diagnóstico de doença celíaca em adultos diagnosis of celiac disease in adults

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ID: 149906
2010
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Abstract
Doença celíaca (DC) é uma doença caracterizada por intolerância à ingestão de glúten, contido em cereais como cevada, centeio, trigo e malte, em indivíduos geneticamente predispostos. As manifestações clínicas da DC variam desde pacientes assintomáticos até formas graves de síndromes má absortivas, podendo envolver múltiplos sistemas e aumentar o risco de algumas neoplasias. O diagnóstico da DC, muitas vezes, exige alto grau de suspeita. Não há um único teste para esse diagnóstico, que é firmado após a associação de dados clínicos e laboratoriais. O primeiro passo no diagnóstico pode ser um teste sorológico como os anticorpos antitransglutaminase tecidual ou antiendomísio. Se a sorologia for positiva, faz-se necessária biópsia duodenal para confirmação diagnóstica. A deficiência de IgA, que ocorre em 3% dos pacientes com DC, pode ser causa de falso-negativos, já que a sorologia é baseada em anticorpos IgA. Outra causa de exames falso-negativos é a restrição de glúten na dieta, por isso, a investigação diagnóstica deve ser realizada na vigência de dieta com glúten. O rastreamento de DC em indivíduos assintomáticos não está indicado.
Celiac disease (CD) is found in genetically predisposed individuals, and charaterized by an intolerance to ingestion of gluten, contained in cereals such as barley, rye, wheat and malt. Clinical manifestations of CD vary from asymptomatic patients to severe forms of malabsorption syndromes, which may involve multiple systems and increase the risk of some malignancies. Diagnosis of CD requires a high degree of suspicion. There is no single test for the diagnosis, which is reached after a combination of clinical and laboratory data. The first step for diagnosis is a serum test such as tissue antitransglutaminase, antibodies or antiendomisio. If serum result is positive, prompt duodenal biopsy is necessary for diagnostic confirmation. An IgA deficiency, which occurs in 3% of patients with DC, may lead to false-negatives because serology is based on IgA. Another situation of false-negative tests is diet restriction of gluten; therefore diagnostic investigation must be carried out during a diet containing gluten. The screening for CD in asymptomatic individuals is not indicated.
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Authors ;Tatiana Sudbrack da Gama e Silva;Tania Weber Furlanetto
Journal acta crystallographica section e
Year 2010
DOI
10.1590/S0104-42302010000100027
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302010000100027
Keywords
diagnosis celiac disease diagnóstico

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