İleri yaşta tanı konulan çölyak hastalığı: sessiz seyir mi, gecikmiş tanı mı?

Yıl 2020, Cilt: 1 Sayı: 2, 46 - 48, 28.06.2020

Alpaslan Tanoğlu

Öz

Çölyak hastalığı (ÇH), genetik olarak duyarlı kişilerde gluten ve gluten benzeri tahıl proteinlerine karşı kalıcı intoleransa bağlı olarak gelişen kronik bir hastalıktır. Genellikle çocukluk ve genç erişkinlik döneminde tanı konulmakla birlikte herhangi bir yaş grubunda gelişebilir. ÇH prevalansı tüm dünyada yaşlı popülasyonda artmaktadır. Bu yaş grubundaki atipik klinik görünüm ve farklı laboratuvar bulgular tanıda hatalara ve gecikmelere neden olmaktadır. Bu olgu sunumunda, halsizlik ve demir eksikliği anemisi nedeniyle kliniğimize yönlendirilen ve ÇH tanısı konulan 61 yaşındaki bayan hastamızı ele aldık. Böylece ileri yaştaki ÇH vakalarına tanısal yaklaşımdaki farkındalığı arttırmayı, tanıdaki gecikmeleri önlemeyi ve bu yaş grubu anemik hastalarda endoskopik değerlendirmenin önemini vurgulamayı hedefledik.

Anahtar Kelimeler

Çölyak hastalığı, yaşlı populasyon, endoskopi

Destekleyen Kurum

yok

Proje Numarası

yok

Celiac disease diagnosed at an advanced age: silent course or delayed diagnose?

Öz

Celiac disease (CD) is a chronic disease that develops due to permanent intolerance to gluten and gluten-like grain proteins in genetically susceptible individuals. Although it is usually diagnosed in childhood and young adulthood, it can develop in any age group. The prevalence of CD is increasing worldwide in the elderly population. Atypical clinical appearance and different laboratory findings in this age group cause errors and delays in diagnosis. In this case report, we discussed a 61-year-old female patient who was referred to our clinic due to weakness and iron deficiency anemia and diagnosed with CD. Thus, we aimed to increase awareness in the diagnostic approach to older cases of CD, to prevent delays in diagnosis and to emphasize the importance of endoscopic evaluation in anemic patients in this age group.

Anahtar Kelimeler

celiac disease, elderly population, endoscopy

Proje Numarası

yok

Kaynakça

• 1. Makovicky P, Makovicky P, Caja F, Rimarova K, Samasca G, Vannucci L. Celiac Disease and Gluten-Free Diet: Past, Present, and Future? Gastroenterol Hepatol Bed Bench. 2020 Winter;13:1-7. 2. Hujoel IA, Murray JA. Refractory Celiac Disease. Curr Gastroenterol Rep 2020;22:18. 3. Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA, Everhart JE. The prevalence of celiac disease in the United States. Am J Gastroenterol. 2012;107:1538–44. 4. Cappello M, Morreale GC, Licata A. Elderly Onset Celiac Disease: A Narrative Review. Clin Med Insights Gastroenterol 2016;9:41-9. 5. Murray JA, Van Dyke C, Plevak MF, Dierkhising RA, Zinsmeister AR, Melton LJ. III Trends in the identification and clinical features of celiac disease in a North American community, 1950–2001. Clin Gastroenterol Hepatol. 2003;1:9–27. 6. Patel D, Kalkat P, Baisch D, et al. Celiac disease in the elderly. Gerontology. 2005;51:213–4. 7. Vilppula A, Collin P, Maki M, et al. Undetected coeliac disease in the elderly: a biopsy-proven population-based study. Dig Liver Dis. 2008;40:809–13. 8. Green PH. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology. 2005;128(4 suppl 1):S74–S78. 9. Freeman HJ. Adult celiac disease in the elderly. World J Gastroenterol. 2008;14:6911–14. 10. Holt PR. Intestinal malabsorption in the elderly. Dig Dis. 2007;25:144–50. 11. Baghbanian M, Farahat A, Vahedian HA, Sheyda E, Zare-Khormizi MR. The prevalence of celiac disease in patients with iron-deficiency anemia in center and south area of Iran. Arq de gastroenterologia. 2015;52:278–82. 12. Rashtak S, Murray J. Celiac disease in the elderly. Gastroenterol Clin North Am. 2009;38:433–46. 13. Düzenli T, Tanoglu A. Liver manifestations of celiac disease. J Ist Faculty Med 2017; 80:111-9. 14. Rubio-Tapia A, Murray JA. Liver involvement in celiac disease. Minerva Med. 2008;99:595–04. 15. Vivas S, Ruiz de Morales JM, Fernandez M, et al. Age-related clinical, serological, and histopathological features of celiac disease. Am J Gastroenterol. 2008;103:2360–65.