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Ultima descărcare din IBN: 2024-02-15 14:33 |
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616.34-008.1-07-053.2 (2) |
Patologia sistemului digestiv. Tulburări ale tubului alimentar (1732) |
SM ISO690:2012 MIHU, Ion, PAUN, Grigore, PETROVICI, Virgil, TIGHINEANU, Olga, BĂDĂRĂU, Svetlana. Optimizarea managemntului de diagnostic neinvaziv și precoce al bolii celiace la copii . In: Buletin de Perinatologie, 2022, nr. 1(93), pp. 149-155. ISSN 1810-5289. |
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Buletin de Perinatologie | ||||||
Numărul 1(93) / 2022 / ISSN 1810-5289 | ||||||
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CZU: 616.34-008.1-07-053.2 | ||||||
Pag. 149-155 | ||||||
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Keywords: Celiac disease, TGA-IgA, histological examination, children. Introduction. Celiac disease is a condition caused by intolerance to gluten and related proteins (wheat, barley, rye, and oats) in genetically susceptible people. The global prevalence of celiac disease is between 0.7% and 1.4%, depending on age, sex, and geographic location. Because of the atypical manifestation of Celiac disease, the average age of diagnosis in developed countries has increased over the last decades, from 2 years to 6-9 years. According to the New Guidelines for the Diagnosis, ESPGHAN, 2020, increased values of TGA-IgA (≥10xULN) and positive EMA exclude the need for endoscopic and histological examination to confirm the disease. Thus, optimizing the non-invasive diagnosis of celiac disease is a challenge for modern medicine. Objective of the study. To estimate the interrelationship between clinical manifestations, TTG-IgA levels, and endoscopic and histological examination in children with celiac disease. Material and methods. The research was carried out in the Gastroenterology and Hepatology Department, PMSI Mother and Child Institute, and the patients were monitored in the Integrated Specialized Consultative Department. The clinical examination and paraclinical investigations were used to make the final diagnosis, which highlighted age-related clinical features and was correlated with serological, endoscopic, and histological tests. 40 children with celiac disease were enrolled in the study, including 20 patients (group A) with TGA-IgA levels (≥5xULN) and 20 patients (group B) with TGA-IgA levels (≥10xULN). Results. The typical form was found in 33.33% of preschoolers and the atypical form in 66.67% of junior and senior schoolchildren. The main digestive clinical manifestations revealed were as follows: abdominal pain — 73.62%; decreased appetite — 84.43%; weight retardation — 71.82%; stature retardation — 59.46%; unformed stool — 33.38%; vomiting — 31.03%. Extra-digestive manifestations were present in 66.38% of cases, hematological manifestations, refractory anemia — 46.8%, mucocutaneous – 39.66%, endocrine — 34.2%, articular manifestations – 12.07%, late dental eruption (after the age of 1 year) – 9.08%, ophthalmological (recurrent chalazions) — 4%. Increased values of TGA-IgA (≥5xULN), as well as ≥10xULN had the same endoscopic and histological peculiarities of deformation and flattening of the destructive infiltrative-cellular mucosa, in various proliferative-epithelial ratios. Conclusions. The TGA-IgA (≥5XULN) and TGA-IgA (≥10xULN) levels are elevated, among other clinical manifestations, during endoscopic and histological examination. |
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Cuvinte-cheie Celiac disease, TGA-IgA, histological examination, children, целиакия, ТGА-IgA, гистологическое исследование, дети |
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