Author/Editor     Križnar, Tomaž
Title     Zanesljivost serumskih antigliadinskih in antiendomizijskih protiteles kot kazalcev prisotnosti atrofije sluznice tankega črevesa pri celiakiji v otroški dobi
Translated title     The reliability of serum antigliadin and antiendomysial antibodies as indicators of children with small intestinal mucosa atrophy in coeliac disease
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 35, št. 4
Publication year     1996
Volume     str. 457-71
Language     slo
Abstract     We set out to introduce serum markers into the diagnosis of coeliac disease as a substitute or supplement to small intestinal mucosa biopsy. At the Paediatrics Department of the Maribor Teaching Hospital, determinations of antigliadin (AGA-IgA and AGA-IgG) and antiendomysial antibodies are carried out in to asses the reliability of these coeliac disease markers in indicating the state of small intestinal mucosa. We examined the records of 74 children in which small intestinal mucosa biopsy had been pertormed and ANTIGLIADIN as well as ANTIENDOMYSIAL antibodies had been determined at the same time. According to the degree of small intestinal mucosa atrophy they were assigned to the following three groups:1. 24 children with normal small intestinal mucosa, 2. 30 children with partial or moderate atrophy and 3. 20 children with total atrophy of the small intestinal mucosa. For all markers the connection with the degree of small intestinal mucosa atrophy was proven (p<0.0001 in all markers). The reliability of negative markers as indicators of healthy mucosa lay between 44.4% and 57.1 % for all markers and combinations. The reliability of positive serum markers was absolute (l00%) for the following markers: AGA-IgA, for the combinations AGA-IgA+AGA-IgG and AGA-IgA+EMA as well as for the combination of all three markers. A positive ANTIENDOMYSIAL was reliable in 95.2% and AGA-IgG in 78.6%. We belive that in children in which all three markers of celiac disease are positive, it would be reasonable to contemplate whet- her small intestinal mucosa biopsy is justified.
Summary     V diagnostiko celiakije poskušamo vpeljati serumske označevalce, ki bi nadomestili ali dopolnili biopsijo sluznice tankega črevesa. Na otroškem oddelku mariborske bolnišnice določamo antigliadinska (AGA-IgA ter AGA-IgG) in antiendomizijska protitelesa. Zeleli smo ugotoviti, kako zanesljivo omenjeni serumski označevalci celiakije pokažejo stanje črevesne sluznice. Pregledali smo dokumentacijo 74 otrok, pri katerih je bila opravljena biopsija sluznice tankega črevesa in so imeli istočasno določena tudi antigliadinska in antiendomizijska protitelesa. Glede na stopnjo atrofije sluznice tankega črevesa smo oblikovali tri skupine. V prvi skupini je bilo 24 otrok z normalno sluznico, v drugi 30 otrok z delno ali zmerno atrofijo in v tretji 20 otrok s popolno atrofijo črevesne sluznice. Za vse označevalce smo dokazali povezanost s stopnjo atrofije sluznice tankega črevesa. Zanesljivost negativnih označevalcev kot kazalcev zdrave sluznice se je za vse označevalce in kombinacije gibala med 44,4% in 57,1%. Zanesljivost pozitivnih serumskih označevalcev pa je bila popolna (100-odstotna) za označevalce: AGA-IgA, za kombinaciji AGA-IgA+AGA-IgG in AGA-Ig- A+EMA ter za kombinacijo vseh treh označevalcev. Pozitivni označevalec antiendomizijskih protiteles je bil zanesljiv v 95,2% in AGA-IgG v 78,6%. Menimo, da bi bilo pri otrocih s pozitivnimi vsemi tremi označevalci celiakije smiselno razmisliti o upravičenosti biopsije sluznice tankega črevesa.
Descriptors     CELIAC DISEASE
GLIADIN
INTESTINE, SMALL
ATROPHY
IGA
IGG
GLUTEN
MUSCLE, SMOOTH
BIOPSY
INFANT
CHILD, PRESCHOOL
CHILD
ADOLESCENCE
ANTIBODIES