Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 216
Filtrar
1.
Nutrients ; 11(4)2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30987328

RESUMO

This study aimed to translate, culturally adapt, validate, and apply a questionnaire to the Brazilian non-celiac gluten sensitive (NCGS) population. We also aimed to estimate the prevalence of symptoms which affect Brazilian NCGS. The Brazilian Portuguese version of the NCGS questionnaire was developed according to revised international guidelines. Five-hundred-and-fourty-three participants responded the NCGS questionnaire. We evaluated the reproducibility and validity of the questionnaire which presents valid measures of reproducibility. This is the first specific self-reported validated questionnaire for NCGS patients in Brazilian Portuguese, and the first nationwide characterization of self-reported NCGS in Brazilian adults. Most respondents were female (92.3%), and the main intestinal symptoms reported were bloating and abdominal pain. The most frequent extraintestinal symptoms were lack of wellbeing, tiredness, and depression. We expect that the present study will provide a picture of Brazilian individuals with suspected NCGS, which could help health professionals and governmental institutions in developing effective strategies to improve the treatment and diagnosis of Brazilian NCGS.


Assuntos
Dor Abdominal/diagnóstico , Características Culturais , Autorrelato , Tradução , Hipersensibilidade a Trigo/diagnóstico , Dor Abdominal/epidemiologia , Adulto , Brasil/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Reprodutibilidade dos Testes , Hipersensibilidade a Trigo/epidemiologia
2.
J Investig Allergol Clin Immunol ; 29(2): 118-123, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31017108

RESUMO

BACKGROUND AND OBJECTIVE: Wheat ingestion can lead to disorders such as IgE-mediated food allergy and wheat-dependent exercise-induced anaphylaxis (WDEIA), both of which are associated with impaired quality of life and significant morbidity. Allergy to wheat is relatively benign in children, although its natural history in adults is still unknown. Objective: We used placebo-controlled challenge to evaluate the natural history of wheat hypersensitivity in atopic patients with adultonset wheat allergy. METHODS: We enrolled 13 patients from an initial cohort of adult patients with IgE-mediated wheat allergy (mean age, 40 years). After diagnosis, the patients observed a wheat-free diet and were followed as outpatients for 5 years to evaluate wheat exposure. Wheat-IgEtiters were determined at the end of follow-up, and a second wheat-challenge was performed. RESULTS: Ten out of 13 patients took part in the study. The mean period of wheat avoidance was 4.2 years. Three patients had spontaneously reintroduced wheat before the second evaluation, after a mean (IQR) of 28 (18-36) months, with only mild gastrointestinal discomfort at reintroduction. At the end of follow-up, 9 of the 10 patients were wheat-tolerant. Two patients had a history of WDEIA. We observed a reduction in IgE levels, with median (IQR) IgE falling from 2.77 (0.35-100) kU/L at diagnosis to 0.88 (0.1-20.8) kU/L. The association between IgE and a negative challenge result was not statistically significant. CONCLUSION: IgE-mediated wheat allergy in adults is benign and represents a temporary break in gastrointestinal tolerance. Future studies may improve our knowledge of wheat allergens, routes of and factors leading to sensitization, and prognostic biomarkers.


Assuntos
Hipersensibilidade a Trigo/epidemiologia , Adolescente , Adulto , Alérgenos/imunologia , Reações Cruzadas/imunologia , Feminino , Seguimentos , Humanos , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Prognóstico , Testes Cutâneos , Triticum/efeitos adversos , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/imunologia , Adulto Jovem
3.
Molecules ; 24(6)2019 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-30909404

RESUMO

The prevalence of wheat allergy has reached significant levels in many countries. Therefore, wheat is a major global food safety and public health issue. Animal models serve as critical tools to advance the understanding of the mechanisms of wheat allergenicity to develop preventive and control methods. A comprehensive review on the molecular mechanisms of wheat allergenicity using animal models is unavailable at present. There were two major objectives of this study: To identify the lessons that animal models have taught us regarding the molecular mechanisms of wheat allergenicity and to identify the strengths, challenges, and future prospects of animal models in basic and applied wheat allergy research. Using the PubMed and Google Scholar databases, we retrieved and critically analyzed the relevant articles and excluded celiac disease and non-celiac gluten sensitivity. Our analysis shows that animal models can provide insight into the IgE epitope structure of wheat allergens, effects of detergents and other chemicals on wheat allergenicity, and the role of genetics, microbiome, and food processing in wheat allergy. Although animal models have inherent limitations, they are critical to advance knowledge on the molecular mechanisms of wheat allergenicity. They can also serve as highly useful pre-clinical testing tools to develop safer genetically modified wheat, hypoallergenic wheat products, novel pharmaceuticals, and vaccines.


Assuntos
Alérgenos/imunologia , Triticum/efeitos adversos , Hipersensibilidade a Trigo/etiologia , Alérgenos/química , Animais , Modelos Animais de Doenças , Manipulação de Alimentos , Inocuidade dos Alimentos , Humanos , Imunização , Imunoglobulina E/imunologia , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/prevenção & controle , Hipersensibilidade a Trigo/terapia
4.
Int Arch Allergy Immunol ; 179(2): 132-141, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30897589

RESUMO

BACKGROUND: Diagnosing both celiac disease (CD) and wheat allergy (WA) might be challenging due to the increasingly popular gluten-free diets. OBJECTIVES: This study investigates the value of anti-tissue transglutaminase IgA (tTGIgA) and wheat-specific IgE (WIgE), and identifies clinical and serological features associated with CD and WA. METHOD: Serological markers of autoimmunity and allergy along with medical charts of patients assessed for tTGIgA and WIgE between 2010 and 2016 were evaluated. RESULTS: During the last years, an increasing number of patients have been tested for tTGIgA, while the number of positive results decreased linearly. Among the 2,965 patients included, 128 patients showed at least once a positive tTGIgA. All patients with tTGIgA levels higher than the 12-fold upper normal limit had CD. The ratio of tTGIgA/total IgA did not perform better as a diagnostic test for CD compared to tTGIgA. tTGIgA and anti-nuclear antibodies were significantly associated. WA was only rarely investigated, particularly in adults. However, positive WIgE were found in nearly 50% of the cases. WIgE and tTGIgA values were negatively correlated. CONCLUSIONS: tTGIgA were increasingly tested, while the rate of positive results decreased in recent years, possibly reflecting the impact of current alimentary trends on clinical practice. Associated autoimmune disease was frequently found in CD. High levels of tTGIgA accurately predicted CD diagnosis. WA was rarely investigated and deserves more attention, in particular in children with atopic background. WA does not seem to be associated with CD.


Assuntos
Doença Celíaca/diagnóstico , Hipersensibilidade a Trigo/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Especificidade de Anticorpos/imunologia , Biomarcadores , Biópsia , Doença Celíaca/prevenção & controle , Criança , Pré-Escolar , Comorbidade , Diagnóstico Diferencial , Dieta Livre de Glúten , Feminino , Proteínas de Ligação ao GTP/imunologia , Glutens/efeitos adversos , Glutens/imunologia , Humanos , Imunoglobulina A/imunologia , Imunoglobulina E/imunologia , Lactente , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Curva ROC , Transglutaminases/imunologia , Hipersensibilidade a Trigo/prevenção & controle , Adulto Jovem
5.
Vnitr Lek ; 65(1): 19-23, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30823833

RESUMO

Non-celiac gluten/wheat sensitivity (NCG/WS) is a syndrome characterized by intestinal and extra-intestinal sym-ptoms elicited by gluten/wheat ingestion in the persons, who are not affected by celiac disease and wheat allergy. Due to the lack of established biomarkers, the diagnosis of NCG/WS is based on the clinical picture, and it is necessary to validate it in well-defined double-blind, placebo-controlled challenge (The Salerno Experts´ Criteria). In the article is discussed a current knowledge of NCG/WS in terms of pathogenesis, diagnosis and treatment. Key words: gluten - gluten-related disorders - non-celiac gluten/wheat sensitivity - wheat.


Assuntos
Doença Celíaca , Hipersensibilidade a Trigo , Doença Celíaca/diagnóstico , Doença Celíaca/dietoterapia , Dieta Livre de Glúten , Método Duplo-Cego , Glutens , Humanos , Triticum , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/tratamento farmacológico
6.
J Gastrointestin Liver Dis ; 28(1): 95-105, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30851178

RESUMO

BACKGROUND AND AIMS: The epidemiology of gluten-related disorders (GRDs) is still an open field to be explored. We conducted this systematic review based on the current epidemiology knowledge of GRDs, focusing on the changing prevalence of GRDs reported in the Asia-Pacific region. METHODS: We searched Medline, PubMed, Scopus, Web of Science and Cochrane database with the following MeSH terms and keywords: celiac disease (CD), wheat allergy (WA), non-celiac gluten sensitivity (NCGS), dermatitis herpetiformis (DH) and gluten ataxia (GA) and the prevalence studies published from January 1991 to January 2018. Each article was cross-referenced with "Asia-Pacific region" and countries in this region such as Australia, New Zealand, India, Pakistan, Turkey, Iran and others. RESULTS: We included 66 studies, which reported the prevalence of GRDs in the Asia-Pacific region. Prevalence of celiac disease was 0.32%-1.41% in healthy children and 0.05%-1.22% in the adult population, while the prevalence in the high risk population was higher (0.6%-11.8%). Previous studies have shown a very low incidence of dermatitis herpetiformis (DH) (<0.001%) and gluten ataxia (GA) in this area. Few studies on NCGS outbreaks have been found in this area due to the lack of specific diagnostic biomarkers. Wheat allergy (WA), although uncommon in most Asian-Pacific countries, is the most common cause of anaphylaxis in this region. CONCLUSION: The results of this systematic review suggest the need to plan further proper epidemiological studies in order to understand the natural history of GRDs and to assess its burden on health systems.


Assuntos
Doença Celíaca/epidemiologia , Glutens/efeitos adversos , Hipersensibilidade a Trigo/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Austrália/epidemiologia , Doença Celíaca/diagnóstico , Doença Celíaca/imunologia , Criança , Pré-Escolar , Glutens/imunologia , Humanos , Incidência , Lactente , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Fatores de Risco , Fatores de Tempo , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/imunologia , Adulto Jovem
7.
Gastroenterol Clin North Am ; 48(1): 165-182, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711208

RESUMO

Non-celiac wheat sensitivity (NCWS) is characterized by gastrointestinal and extra-intestinal symptoms following the ingestion of gluten-containing cereals in subjects without celiac disease or wheat allergy. The identity of the molecular triggers in these cereals responsible for the symptoms of NCWS remains to be delineated. Recent research has identified a biological basis for the condition, with the observation of systemic immune activation in response to microbial translocation that appears to be linked to intestinal barrier defects. Ongoing research efforts are aimed at further characterizing the etiology, mechanism, and biomarkers of the condition.


Assuntos
Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/imunologia , Imunidade Adaptativa , Adulto , Doença Celíaca , Dieta Livre de Glúten , Feminino , Microbioma Gastrointestinal , Humanos , Imunidade Inata , Mucosa Intestinal/imunologia , Masculino , Pessoa de Meia-Idade , Hipersensibilidade a Trigo/fisiopatologia
8.
J Coll Physicians Surg Pak ; 29(1): 51-57, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30630570

RESUMO

Non-celiac gluten sensitivity (NCGS) is a wheat associated disorder diagnosed by exclusion diagnosis. This review was conducted to collect current information about NCGS, clinical and pathologic manifestations, and problems faced by health professionals. It also highlights the obstacles faced when adopting a gluten-free diet. A search of international literature was conducted through PubMed and Google Scholar till September 2017. The heterogeneous groups of patients affected by NCGS are composed of a number of subgroups, and each demonstrates different clinical and pathological manifestations. The presence of certain underlying factors can be utilised to identify susceptible individuals, namely, incidence of food allergies in infancy, anti-gliadin IgG-antibodies, activation test for flow cytometric basophils, atopy, and increased intraepithelial duodenal eosinophil presence. There is urgent need for reliable biomarkers to decisively diagnose and differentiate NCGS from related disorders. Patients willing to adopt gluten-free products have to choose from products which have high fat and sugar content.


Assuntos
Hipersensibilidade Alimentar/diagnóstico , Gastroenteropatias/etiologia , Glutens/efeitos adversos , Glutens/imunologia , Hipersensibilidade a Trigo/diagnóstico , Dieta Livre de Glúten , Gastroenteropatias/diagnóstico , Humanos , Hipersensibilidade a Trigo/imunologia
10.
Med Clin North Am ; 103(1): 89-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30466678

RESUMO

Historically, a gluten-free diet was recommended only for those with celiac disease or IgE-mediated wheat allergy. With changes in food allergy labeling in the United States and the publication of several best-selling books, gluten-related disorders have come to the forefront of popular culture. As a result, there has been a dramatic increase in the number of gluten-free diet followers, many for nontraditional reasons. As "going gluten-free" has become mainstream, it is imperative that health care providers acquire the knowledge to identify true gluten-related disorders to effectively counsel their patients and minimize potential complications from following such a restrictive diet.


Assuntos
Doença Celíaca/diagnóstico , Dieta Livre de Glúten , Glutens/imunologia , Hipersensibilidade a Trigo/diagnóstico , Doença Celíaca/dietoterapia , Diagnóstico Diferencial , Clínicos Gerais , Humanos , Hipersensibilidade a Trigo/dietoterapia
13.
Nutrients ; 10(10)2018 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-30279386

RESUMO

Gluten is the trigger for celiac disease (CD), non-celiac gluten/wheat sensitivity (NCGS), and wheat allergy. An oral food challenge is often needed for diagnosis, but there are no standardized gluten challenge materials with known composition available. To fill this gap, two materials, commercially available gluten and a food-grade gluten hydrolysate (pepgluten), were extensively characterized. Pepgluten was prepared from gluten by incubation with a pepsin dietary supplement and acetic acid at 37 °C for 120 min. The components of pepgluten were crude protein (707 mg/g), starch (104 mg/g), water (59 mg/g), fat (47 mg/g), dietary fiber (41 mg/g) and ash (11 mg/g). The protein/peptide fraction of pepgluten (1 g) contained equivalents derived from 369 mg gliadins and 196 mg glutenins, resulting in 565 mg total gluten equivalents, 25 mg albumins/globulins, 22 mg α-amylase/trypsin inhibitors and 48 mg pepsin capsule proteins. The slightly acidic, dough-like smell and bitter taste of pepgluten could be completely camouflaged in multivitamin juice with bitter lemon, grapefruit juice, or vegetable and fruit smoothies. Thus, pepgluten met the criteria for placebo-controlled challenges (active and placebo materials are identical regarding appearance, taste, smell, and texture) and is appropriate as a standard preparation for the oral food challenge and clinical investigations to study wheat hypersensitivities.


Assuntos
Glutens/química , Testes Imunológicos/métodos , Hidrolisados de Proteína , Triticum/química , Hipersensibilidade a Trigo/diagnóstico , Doença Celíaca/diagnóstico , Gliadina , Humanos
14.
Ear Nose Throat J ; 97(9): 296-322, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30273429

RESUMO

Rates of allergy-test positivity vary by country and by regions within countries. Several studies have looked at allergy test results to determine the most common allergens. Many of these studies have been based on surveys or on studies of small numbers of tests. Positivity rates for allergy tests are poorly defined in the northern midwestern region of the United States. We conducted a study to identify the rates of positive allergy tests for both inhalant/respiratory allergens and food allergens in the upper Midwest. We extracted from our laboratory database the results of all test samples sent for one of eight allergen panels that had been analyzed between Sept. 1, 2014, and Sept. 1, 2015. All testing was performed at The Cleveland Clinic with the Phadia ImmunoCAP system. The percentage of positive tests, the distribution of the most frequently positive tests, and the class of in vitro responses were identified. A total of 148,628 test results for 63 different allergens were identified. Of the 125,190 tests for inhalant/respiratory allergens, the most frequently positive were dog dander (24% of tests), cat dander (23%), dust mites (23% for both Dermatophagoides pteronyssinus and Dermatophagoides farinae), and June grass (21%). Of the 23,438 food tests, the most frequently positive test results were for milk (18%), peanut (17%), wheat (16%), and egg white (15%). Most of the results fell into classes 1 through 3, although there was still a notable number of very high responses (class 5 and 6). These findings suggest that there is wide variability in the positivity of in vitro allergy tests and that the likelihood of a positive result in screening panels can be estimated. Evaluating such rates will help identify the most and least common allergens and will help to cost-effectively refine allergy screening panels.


Assuntos
Alérgenos/efeitos adversos , Doença Ambiental/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Animais , Gatos , Dermatophagoides farinae , Dermatophagoides pteronyssinus , Cães , Hipersensibilidade a Ovo/diagnóstico , Hipersensibilidade a Ovo/epidemiologia , Doença Ambiental/diagnóstico , Feminino , Hipersensibilidade Alimentar/diagnóstico , Humanos , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Amendoim/diagnóstico , Hipersensibilidade a Amendoim/epidemiologia , Poaceae/efeitos adversos , Prevalência , Pyroglyphidae , Testes Cutâneos , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/epidemiologia
15.
J Gastrointestin Liver Dis ; 27(3): 241-247, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30240467

RESUMO

BACKGROUND AND AIMS: There is increasing evidence regarding elevated serum levels of inflammatory cytokines in patients with celiac disease (CD), but little is known about their levels in patients with non-celiac gluten sensitivity (NCGS). The aim of this study was to evaluate the serum levels of inflammatory cytokines in Iranian patients with CD and NCGS and to compare them with those of healthy individuals. METHODS: A total of 110 treated CD, 15 with NCGS, and 46 healthy subjects were enrolled during 2016. Serum levels of IL-1, IL-6, IL-8, IL-15 and IFN-γ were measured using ELISA, and compared between groups. The correlation of the severity of mucosal damage and clinical symptoms with serum levels of cytokines was also assessed. RESULTS: The mean serum levels of IFN-γ (p = 0.04) and IL-6 (p = 0.007) were significantly different between the patients in the CD and control groups, and IL-8 was significantly higher in the CD group compared with patients in the NCGS group (p = 0.04). Statistically significant correlations were observed between the serum levels of IFN-γ and abortion (p = 0.01), IL-1 and weight loss (p = 0.043) and infertility (p = 0.0001) in CD patients, and between IFN-γ and abortion (p = 0.01) and infertility (p = 0.01) in the NCGS patients. Moreover, no significant relationship was observed between the severity of mucosal damage and the serum level of the studied cytokines. CONCLUSIONS: Inflammatory cytokines are implicated in the pathogenesis of CD, and their serum levels might help to identify a diagnostic marker to differentiate CD from NCGS. However, further studies with a larger sample size are recommended.


Assuntos
Doença Celíaca/sangue , Citocinas/sangue , Mediadores da Inflamação/sangue , Hipersensibilidade a Trigo/sangue , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Doença Celíaca/diagnóstico , Doença Celíaca/imunologia , Citocinas/imunologia , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Mediadores da Inflamação/imunologia , Irã (Geográfico) , Masculino , Valor Preditivo dos Testes , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/imunologia
16.
Turk J Gastroenterol ; 29(4): 515-517, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30249570

RESUMO

Celiac disease (CD) and concomitant wheat allergy are not commonly described in the literature. Both can have almost the same treatment consisting of a gluten-free or wheat-free diet. On the other hand, they are based on totally different pathogenetic mechanisms and can be easily underdiagnosed, particularly CD. We describe a peculiar case of a young female patient affected by wheat allergy whose serological and histological data were not diagnostic for CD. Organ culture system successfully detected specific antibodies for CD in duodenal biopsy supernatant, supporting the diagnosis of CD.


Assuntos
Doença Celíaca/diagnóstico , Hipersensibilidade a Trigo/diagnóstico , Adulto , Biópsia , Doença Celíaca/complicações , Doença Celíaca/imunologia , Duodeno/imunologia , Duodeno/patologia , Feminino , Humanos , Testes Sorológicos , Hipersensibilidade a Trigo/complicações , Hipersensibilidade a Trigo/imunologia
18.
Pediatr. aten. prim ; 20(79): 269-276, jul.-sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180955

RESUMO

La celiaquía puede considerarse (como antes la sífilis) "la gran simuladora". Una enfermedad prevalente con nuevos matices y diferentes formas de presentación, incluyendo la silente. En relación con la ingesta de cereales están apareciendo otras enfermedades no celíacas, pero que mejoran al retirar el trigo. En este artículo se hace una actualización de la celiaquía y de las enfermedades relacionadas con la ingesta de cereales


Celiac disease can be considered "the great pretender" (as syphilis some years ago). A prevalent disease with different presentations, including silent ones. In relation to diet with cereals, other non-celiac diseases are appearing, that also improve removing wheat. The fact that it's being diagnosed in adults, adds complexity because protocols are somehow different than protocols in children. New data about celiac disease and other syndromes related to cereals help clarify practical management


Assuntos
Humanos , Doença Celíaca/diagnóstico , Dieta Livre de Glúten/tendências , Glutens/efeitos adversos , Hipersensibilidade a Trigo/diagnóstico , Intolerância Alimentar/diagnóstico , Diagnóstico Diferencial , Hipersensibilidade Alimentar/diagnóstico
19.
Virchows Arch ; 473(5): 551-558, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30094491

RESUMO

Intraepithelial lymphocytosis (IELosis) with or without villous abnormality is a characteristic feature of gluten sensitivity (GS) including celiac disease (CD) and non-celiac-GS, although various conditions may also be associated with IELosis. In order to distinguish GS from the other causes of IELosis, a threshold for IEL counts is necessary. We aimed to determine a cut-off value for IELs and monitor its value in the spectrum of GS in a large cohort. For this purpose, the duodenal biopsies from four groups of individuals including Types 1 (n = 88) and 3 (n = 92) CD, non-CD IELosis (n = 112), and control (n = 82) cases, all strictly defined by their clinical, laboratory, and serologic features, were evaluated. The number of IELs/100 enterocytes and their distribution pattern on H&E- and CD3-immunostained sections were assessed for each group. Kruskal-Wallis test and ROC curve analysis for discriminant value were employed for statistics. The IEL counts showed an increasing trend through the spectrum of mucosal pathology including controls (12.06; 21.40), non-CD IELosis (28.62; 39.46), Type 1 CD (49.27; 60.15), and Type 3 CD (58.53; 71.74) both on H&E- and CD3-immunostained sections, respectively (p < 0.001). ROC analysis revealed 20.5 on H&E and 28.5 on CD3 as the IEL cut-off values with a sensitivity of 95.9 and 87.7% and a specificity of 98.8% and 93.9%, respectively, for controls. IELs showed a diffuse distribution pattern per biopsy piece and per villus (90.9%, 100%, respectively) in nearly all of Type 1 CD cases (p < 0.001). An IEL cut-off value of 20.5 on H&E together with a diffuse distribution pattern seem to be the most discriminant features for the diagnosis of CD, even for the milder forms of the disease.


Assuntos
Doença Celíaca/patologia , Duodeno/patologia , Glutens/efeitos adversos , Mucosa Intestinal/patologia , Linfócitos Intraepiteliais/patologia , Linfocitose/patologia , Hipersensibilidade a Trigo/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Estudos de Casos e Controles , Doença Celíaca/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Linfocitose/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Hipersensibilidade a Trigo/diagnóstico , Adulto Jovem
20.
Nutrients ; 10(8)2018 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-30096784

RESUMO

Gluten related disorders (GRD) represent a wide spectrum of clinical manifestations that are triggered by the ingestion of gluten. Coeliac disease (CD) or gluten sensitive enteropathy is the most widely recognised, but extra-intestinal manifestations have also been increasingly identified and reported. Such manifestations may exist in the absence of enteropathy. Gluten sensitivity (GS) is another term that has been used to include all GRD, including those where there is serological positivity for GS related antibodies in the absence of an enteropathy. Gluten ataxia (GA) is the commonest extraintestinal neurological manifestation and it has been the subject of many publications. Other movement disorders (MDs) have also been reported in the context of GS. The aim of this review was to assess the current available medical literature concerning MDs and GS with and without enteropathy. A systematic search was performed while using PubMed database. A total of 48 articles met the inclusion criteria and were included in the present review. This review highlights that the phenomenology of gluten related MDs is broader than GA and demonstrates that gluten-free diet (GFD) is beneficial in a great percentage of such cases.


Assuntos
Doença Celíaca/complicações , Transtornos dos Movimentos/etiologia , Hipersensibilidade a Trigo/complicações , Adulto , Idoso , Doença Celíaca/diagnóstico , Doença Celíaca/dietoterapia , Dieta Livre de Glúten , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/dietoterapia , Transtornos dos Movimentos/fisiopatologia , Fatores de Risco , Resultado do Tratamento , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/dietoterapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA