Abstract
Çölyak hastalığı genetik yatkınlığı olan bireylerde, glutene karşı sıradışı bağışıklık yanıtı olarak tanımlanır. Çocuklarda ve infantlarda görülen malabsorbsiyonun en sık görülen nedenlerindendir. Emilim bozukluğu buğday, çavdar, arpa ve yulaftaki gliyadin varlığına bağlıdır. İnce bağırsak mukozasında gliyadin peptitleri ile “Human leucocyte antigen” sınıf II moleküllerinin konjugasyonu, klinik bulgulara yol açan immünolojik reaksiyonları tetiklemektedir. Çok geniş bir klinik yelpazesi olmakla birlikte, 6-12 aylar arasında ishalin başlaması karakteristik özelliklerindendir. Demir eksikliği anemisi de çölyak hastalığının sık görülen bulgularındandır. Antig- liyadin, antiendomizyum ve doku transglütaminaz antikorları tanıda yardımcı olmakla birlikte, kesin tanı için ince bağırsak biyopsisi gereklidir. Biyopside total villus atrofisinin olması tanıda altın standarttır. Tedavi amaçlı glutensiz diyet verildiğinde bariz bir iyileşme görülür. Bu yazıda anemi etiyolojisi araştırılırken tespit edilen gluten enteropatili bir olgudan yola çıkılarak anemi ile çölyak hastalığı ilişkisi incelenmiştir
Keywords
References
- Hernandez L, Green PH. Extraintestinal manifestations of celiac disease. Curr Gastroenterol Rep 2006;8:383-9.
- Akın M, Songür Y, Aksakal G. Clinical and laboratory features and, extraintestinal manifestations of Celiac disease in adults. J Clin Anal Med 2012;3:194-7.
- Salmi TT, Collin P, Korponay-Szabó IR, et al. Endomysial anti- body-negative coeliac disease: clinical characteristics and intestinal autoantibody deposits. Gut 2006;55:1746-53.
- Maki M, Lohi O. Celiac Disease. In: Walker WA, Goulet O, Klein- man RE, Sherman PM, Shneider BL, Sanderson IR (eds). Pediatric Gastrointestinal Disease. 4th ed. Ontario: B.C. Decker, 2004: 932- 43.
- Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifesta- tions of celiac disease. Blood 2007:109;412-21.
- Alıcı S, Algün E, Türkdoğan K, Uğraş S, Dülger H. Malabsorpsiyon Sendromu, Dimorfik Anemi ve Osteomalazi ile Karakterize Çöliak Hastalığı (Olgu Sunumu) Turkiye Klinikleri J Gastroenterohepatol 2002;13:94-8.
- Oxentenko AS, Grisolano SW, Murray JA, Burgart LJ, Dierkhising RA, Alexander JA. The insensitivity of endoscopic markers in celi- ac disease. Am J Gastroenterol 2002;97:933-8.
- Çekin A.H, Çekin Y, Sezer C. Celiac disease prevalence in patients with iron deficiency anemia, Turk J Gastroenterol 2012;23:490-5.
- Bilen Ş, Aslanyavrusu M, Bolat A, Ak F. Celiac disease presen- ting with extraintestinal manifestations. Klin Deney Araş Derg 2010;1:211-3.
- Ertekin V, Tosun MS, Küçük N. The prevalence of celiac disease in children with iron-deficiency anemia. Turk J Gastroenterol 2013;24:334-8.
- Dalgıc B, Sarı S, Ozcan B, et al. Turk Colyak Calışma Grubu. The evaluation of factors and symptoms related to celiac disease in Tur- kish children. Turk Arch Ped 2011;46:323-30.
- Hershko C, Camaschella C. How I treat unexplained refractory iron deficiency anemia. Blood 2014;123:326-33.
- Singh P, Arora S, Makharia GK. Presence of anemia in patients with celiac disease suggests more severe disease. Indian J Gastro- enterol 2014;33:161-4.
- Bardella MT, Fredella C, Saladino V, et al. Gluten intolerance: gen- der-and age-related differences in symptoms. Scand J Gastroente- rol 2005;40:15-9.
Abstract
Celiac disease is defined as an abnormal immune response to gluten in a person who has a genetic tendency. It is the most common cause of malabsorption in infants and children. The malabsorption is due to gliadine present in wheat, barley, rye and oat. The conju- gation of gliadine peptides and Human leucocyte antigen class II molecules in the intestinal mucosa pull the trigger for immunologic reactions which prompt the clinical symptoms. Although there is a variable clinical spectrum, initiation of diarrhea at 6-12 months is characteristic. Iron-deficiency anemia also is a common extraintestinal manifestation of celiac disease. Antigliadins, anti-endomisi- um and tissue transglutaminase antibodies are useful for the diagnosis, but intestinal biopsy is necessary for the definitive diagnosis. Total villous atrophy at intestinal biopsy is gold standard for diagnosis. An obvious improvement is seen for follow-up treatment given gluten-free diet. In this paper, the relationship between anemia and celiac disease was discussed on the basis of a case with gluten enteropathy which was detected while searching the etiology of anemia
Keywords
References
- Hernandez L, Green PH. Extraintestinal manifestations of celiac disease. Curr Gastroenterol Rep 2006;8:383-9.
- Akın M, Songür Y, Aksakal G. Clinical and laboratory features and, extraintestinal manifestations of Celiac disease in adults. J Clin Anal Med 2012;3:194-7.
- Salmi TT, Collin P, Korponay-Szabó IR, et al. Endomysial anti- body-negative coeliac disease: clinical characteristics and intestinal autoantibody deposits. Gut 2006;55:1746-53.
- Maki M, Lohi O. Celiac Disease. In: Walker WA, Goulet O, Klein- man RE, Sherman PM, Shneider BL, Sanderson IR (eds). Pediatric Gastrointestinal Disease. 4th ed. Ontario: B.C. Decker, 2004: 932- 43.
- Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifesta- tions of celiac disease. Blood 2007:109;412-21.
- Alıcı S, Algün E, Türkdoğan K, Uğraş S, Dülger H. Malabsorpsiyon Sendromu, Dimorfik Anemi ve Osteomalazi ile Karakterize Çöliak Hastalığı (Olgu Sunumu) Turkiye Klinikleri J Gastroenterohepatol 2002;13:94-8.
- Oxentenko AS, Grisolano SW, Murray JA, Burgart LJ, Dierkhising RA, Alexander JA. The insensitivity of endoscopic markers in celi- ac disease. Am J Gastroenterol 2002;97:933-8.
- Çekin A.H, Çekin Y, Sezer C. Celiac disease prevalence in patients with iron deficiency anemia, Turk J Gastroenterol 2012;23:490-5.
- Bilen Ş, Aslanyavrusu M, Bolat A, Ak F. Celiac disease presen- ting with extraintestinal manifestations. Klin Deney Araş Derg 2010;1:211-3.
- Ertekin V, Tosun MS, Küçük N. The prevalence of celiac disease in children with iron-deficiency anemia. Turk J Gastroenterol 2013;24:334-8.
- Dalgıc B, Sarı S, Ozcan B, et al. Turk Colyak Calışma Grubu. The evaluation of factors and symptoms related to celiac disease in Tur- kish children. Turk Arch Ped 2011;46:323-30.
- Hershko C, Camaschella C. How I treat unexplained refractory iron deficiency anemia. Blood 2014;123:326-33.
- Singh P, Arora S, Makharia GK. Presence of anemia in patients with celiac disease suggests more severe disease. Indian J Gastro- enterol 2014;33:161-4.
- Bardella MT, Fredella C, Saladino V, et al. Gluten intolerance: gen- der-and age-related differences in symptoms. Scand J Gastroente- rol 2005;40:15-9.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2015 |
| Published in Issue | Year 2015 Volume: 25 Issue: 2 |
The Journal of General Medicine is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).