{"id":10464,"date":"2008-01-14T14:12:54","date_gmt":"2008-01-14T11:12:54","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/markeri-boala-celiaca\/"},"modified":"2020-07-10T12:09:58","modified_gmt":"2020-07-10T09:09:58","slug":"markeri-boala-celiaca","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/markeri-boala-celiaca\/","title":{"rendered":"Markeri boala celiac\u0103"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Boala celiac\u0103 <\/strong><\/span>este o enteropatie autoimun\u0103 declan\u015fat\u0103 de ingestia de gluten la persoanele cu predispozi\u0163ie genetic\u0103; se caracterizeaz\u0103 printr-o intoleran\u0163\u0103 cronic\u0103 la frac\u0163iunile solubile \u00een alcool ale glutenului: gliadinul din gr\u00e2u \u015fi prolaminele din orz, secar\u0103 \u015fi ov\u0103z. Dintre acestea, gliadinul reprezint\u0103 cel mai toxic component al glutenului.<!--more--><br \/>Se estimeaz\u0103 c\u0103 <strong>prevalen\u0163a real\u0103 a bolii celiace \u00een popula\u0163ia general\u0103 ar fi \u00een jur de 0.5%<\/strong>.<\/p>\n<p style=\"text-align: justify;\">Printre categoriile de pacien\u0163i cu risc crescut de a dezvolta boala celiac\u0103 se num\u0103r\u0103 rudele de gradul I ale celor cunoscu\u0163i cu aceast\u0103 afec\u0163iune, pacien\u0163ii cu diabet zaharat insulino-dependent, sindrom Sj\u00f6gren, sindrom Down, deficit selectiv de IgA. Boala celiac\u0103 a fost de asemenea descris\u0103 \u015fi la unele persoane cu manifest\u0103ri neurologice de cauz\u0103 incert\u0103: ataxie cerebeloasa, neuropatie, epilepsie, migren\u0103.<\/p>\n<p style=\"text-align: justify;\">Afec\u0163iunea netratat\u0103 se asociaz\u0103 cu o rat\u0103 de morbiditate \u015fi mortalitate crescute, datorit\u0103 posibilit\u0103\u0163ii dezvolt\u0103rii unor tumori maligne gastrointestinale. At\u00e2t modific\u0103rile histopatologice c\u00e2t \u015fi simptomele se remit dup\u0103 introducerea unei diete f\u0103r\u0103 gluten.<\/p>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Clinic. <\/strong>La <em>copii<\/em>, simptomele bolii se pot instala precoce (la v\u00e2rste cuprinse \u00eentre 4 \u015fi 24 luni): diaree cronic\u0103, distensie abdominal\u0103, sc\u0103dere ponderal\u0103, tulbur\u0103ri de cre\u015ftere. Apar frecvent vom\u0103, anorexie, paloare, st\u0103ri de iritabilitate. Mai rar, se descriu constipa\u0163ie sau durere abdominal\u0103 recurent\u0103. Atunci c\u00e2nd diagnosticul se stabile\u015fte tardiv, copiii pot prezenta anemie prin caren\u0163\u0103 de fier \u015fi\/sau acid folic, tulbur\u0103ri de coagulare, pubertate \u00eent\u00e2rziat\u0103.<\/p>\n<p style=\"text-align: justify;\">Unii <em>adul\u0163i <\/em>cu boala celiac\u0103 declar\u0103 c\u0103 au prezentat simptome \u00een copil\u0103rie, dar \u00een majoritatea cazurilor anamneza nu este sugestiv\u0103 pentru a considera un debut precoce al afec\u0163iunii. Adul\u0163ii pot prezenta, ca \u015fi copiii, un tablou clasic de boal\u0103, cu diaree sever\u0103 \u015fi sc\u0103dere ponderal\u0103, dar sunt mult mai frecvent \u00eent\u00e2lnite simptome de gravitate mai mic\u0103, cum ar fi un sindrom dispeptic sau un sindrom de colon iritabil. La aproximativ jum\u0103tate din adul\u0163i se constat\u0103 forme atipice de boal\u0103, inclusiv forme silen\u0163ioase sau forme extraintestinale. Este larg acceptat ast\u0103zi faptul c\u0103 dermatita herpetiform\u0103, o afec\u0163iune buloas\u0103 a pielii, este indus\u0103 de gluten.<\/p>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Diagnostic.<\/strong> Markerii serologici pentru boala celiac\u0103 au ap\u0103rut ini\u0163ial pentru a depista boala \u00een grupul de pacien\u0163i care prezint\u0103 simptome atipice. Ast\u0103zi sunt folosi\u0163i din ce \u00een ce mai mult \u00een <span style=\"color: #00539f;\"><strong>scop de screening<\/strong><\/span> pentru aceast\u0103 boal\u0103.<br \/><span style=\"color: #00539f;\"><a style=\"color: #00539f;\" href=\"\/test-celikey-anticorpi-anti-transglutaminaza-tisulara-iga\/\"><strong>Transglutaminaza tisular\u0103 (tTG)<\/strong><\/a><\/span> a fost identificat\u0103 ca fiind autoantigenul major \u00een boala celiac\u0103. tTG apar\u0163ine unei familii complexe de enzime calciu\u2013dependente care catalizeaz\u0103 formarea leg\u0103turilor \u00eencruci\u015fate dintre proteine. Aceast\u0103 enzim\u0103 este larg r\u0103sp\u00e2ndit\u0103, \u00een multe organe av\u00e2nd rol \u00een asamblarea matricei extracelulare \u015fi \u00een mecanismele de reparare tisular\u0103. \u00cen \u0163esuturile afectate, cum este cazul mucoasei intestinului sub\u0163ire \u00een boala celiac\u0103 netratat\u0103, se \u00eenregistreaz\u0103 nivele crescute de tTG.<\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><p><strong>Test disponibil \u00een laboratoarele Synevo: <\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/anticorpi-anti-transglutaminaza-tisulara-iga-igg-test-celikey\/\">Anticorpi anti-transglutaminaza tisulara IgA, IgG (test Celikey)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>680 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9306\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9306\"\r\n                                data-product_sku=\"IM34\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/anticorpi-anti-gliadin-deamidad-igg\/\">Anticorpi anti-gliadin deamidad IgG<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>440.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=11802\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"11802\"\r\n                                data-product_sku=\"AL600\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style>\n\n<p><\/p><\/div><\/div><p>Astfel, <strong><em>anticorpii IgA \u00eempotriva tTG<\/em> sunt markeri serologici cu specificitate \u00eenalt\u0103 pentru boala celiac\u0103<\/strong> \u015fi dermatita herpetiform\u0103.<\/p><p>Determinarea \u00een serul pacien\u0163ilor a <em>anticorpilor anti-gliadi<\/em>n \u00eempreun\u0103 cu anticorpii anti-transglutaminaz\u0103 tisular\u0103 constituie un instrument non-invaziv, at\u00e2t pentru screening-ul bolii celiace, c\u00e2t \u015fi pentru monitorizarea complian\u0163ei la diet\u0103. De\u015fi studiile au demonstrat superioritatea test\u0103rii anticorpilor IgA anti-transglutaminaz\u0103 tisular\u0103 (testul Celikey), anticorpii anti-gliadin IgG constituie o investiga\u0163ie complementar\u0103, util\u0103 \u00een special la pacien\u0163ii cu deficit selectiv de IgA care asociaz\u0103 boal\u0103 celiac\u0103, la care primul test indic\u0103 de obicei rezultate negative.<\/p><p><strong>Diagnosticul de boal\u0103 celiac\u0103 se confirm\u0103 prin efectuarea biopsiei de mucoas\u0103 intestinal\u0103<\/strong>, la care se constat\u0103 modific\u0103ri caracteristice (leziuni ce variaz\u0103 ca severitate, de la atrofie p\u00e2n\u0103 la dispari\u0163ia vilozit\u0103\u0163ilor intestinale).<sup>1,2,3,4,5,6<\/sup><\/p><hr class=\"wp-block-separator\"\/><p><small><strong>Bibliografie:<\/strong><\/small><\/p><p><small>1. A.V.M. Dahele et al. Serum IgA tissue transglutaminase antibodies in celiac disease and other gastrointestinal diseases. In QJ Med. 2001<br>2. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Tissue Transglutaminase (tTG), Ig A. www.labcorp.com 2003. Ref Type: Internet Communication<br>3. Frances Fischbach. Immunodiagnostics Studies. In A Manual of Laboratory and Diagnostics Tests. Lippincott Williams &amp; Wilkins, USA, 7 ed. 2004, 597-598<br>4. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2006. Ref Type: Catalog<br>5. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Celiac Disease Comprehensive Profile. www.labcorp.com 2003. Ref Type: Internet Communication<br>6. Xavier Bossuyt. Celiac Disease \u2013 General and Laboratory Aspects. In eJIFC, 2006, 17(3), paper 7.<\/small><\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[895],"class_list":["post-10464","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-gastroenterologie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10464","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10464"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10464"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}