Coeliac Disease

Yıl 2017, Cilt: 9 Sayı: 1, 1 - 10, 25.01.2017

Prof. Dr. Deniz Ertem

Öz

Abstract

Celiac disease, an autoimmune enteropathy that primarily affects the small intestine in genetically predisposed individuals, and caused by ingestion of dietary gluten which is found in grain products. The inflammatory response leads to intestinalvilli damage and malabsorption. Prevalence of celiac disease is increasing worldwide. In our country seroprevalence of celiac disease is 1:94 and biopsy-proved disease prevalence is over 1:212. Celiac disease present itself as a malabsorption syndrome and failure to thrive but in recent years, milder or atypical symptoms such as chronic abdominal pain, short stature, delayed puberty or unexplained elevation of transaminase enzymes might be the presenting symptoms. In children with signs andsymptoms of malabsorption or with symptoms suspicious of celiac, celiac specificserologic tests should be followed by endoscopically obtained duodenal biopsies. Lifelong gluten free diet is the only known effective treatment. Exclusion of gluten fromthe diet leads to histological and clinical remission and prevents the development oflong term complications such as intestinal lymphoma and adenocarcinoma.

Anahtar Kelimeler

Celiac disease, gluten, children

Çölyak Hastalığı

Öz

Öz

Çölyak hastalığı genetik yatkınlığı olan bireylerde tahıllarda bulunan bir protein olan gliadine karşı immünolojik olarak gelişen inflamatuvar yanıt sonucu intestinal villuslarda hasar ve klinik olarak malabsorpsiyona neden olan kronik otoimmün bir hastalıktır. Ülkemizde çölyak hastalığı seroprevalansı 1:94, biyopsi ile tanı konulanhasta prevalansı ise 1:212’den yüksektir. Çölyak hastalığı klasik olarak kronik ishal,batın distansiyonu ve büyüme geriliği ile seyreden tipik malabsorpsiyon sendromubulguları ile ortaya çıkabilir; ancak son yıllarda bu klasik tablodan çok, gastrointestinal sistem dışı semptomlarla ortaya çıkan atipik form daha sık görülmektedir. Malabsorpsiyonu düşündüren semptom ve bulguları olan hastalarda ilk basamakta hastalığa spesifik serolojik testler istenerek tarama yapılır. Çölyak hastalığında kesin tanı endoskopik olarak alınan duodenal biyopsilerin histopatolojik olarak incelemesiyle konulabilir. Günümüzde çölyak hastalığının tedavisi ömür boyu glutensiz diyettir. Diyet tedavisi kısa sürede klinik bulgularda, uzun dönemde ise histopatolojik bulgularda düCoeliac Diseasezelmeyi sağladığı gibi, çölyak hastalarında daha sık görülen intestinal lenfoma ve ade-nokarsinoma riskini de azaltmaktadır

Anahtar Kelimeler

Çölyak hastalığı, gluten, çocuk

Kaynakça

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