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001-es BibID:BIBFORM044309
Első szerző:Korponay-Szabó Ilma (gyermekgyógyász)
Cím:Prospective significance of antiendomysium antibody positivity in subsequently verified celiac disease / Korponay-Szabó I. R., B. Kovács J., Lörincz M., Gorácz G., Szabados K., Balogh M.
Dátum:1997
Megjegyzések:BACKGROUND: In order to assess their long-term predictability for the diagnosisof celiac disease, antiendomysium antibody results were compared with the outcomeof the Interlaken diagnostic process. METHODS: Prospective gluten challenge was performed in 153 children withpreviously diagnosed flat small-intestine mucosa. In 90 patients (Group A),endomysium antibodies were initially positive, in seven (Group B) they werenegative, and 56 patients (Group C) had no initial serological results. InIgA-deficient persons, IgG antibodies were also assayed, both by theimmunofluorescent method. RESULTS: Histological relapse rates were 100% (90/90), 14.3% (1/7), and 76.8%(43/56), p < 0.001, in Groups A, B, and C, respectively. Each patient withrelapse also exhibited endomysium antibody positivity during the challenge.Patients in whom celiac disease could be finally ruled out remained consistently endomysium-antibody negative. The celiac disease patient in Group B had severesecondary immunoglobulin deficiency at entry, which explained the initialnegativity. Diagnosis based on antiendomysium antibody positivity and flat mucosagave a higher applicability (92.8 vs. 50.3%) and reliability (relapse rate 100vs. 89.6%) than the 1990 European Society of Paediatric Gastroenterology andNutrition (ESPGAN) criteria among these patients. CONCLUSIONS: Endomysium antibody positivity at presentation has been found to be as useful as gluten challenge in the diagnosis of celiac disease, even inpatients under the age of 2 years. Challenge is still advisable in patients with a flat small intestinal mucosa when antiendomysium antibody results are negative or have not been done, as among these patients significantly lower relapse rates were found.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Journal of Pediatric Gastroenterology and Nutrition. - 25 : 1 (1997), p. 56-63. -
További szerzők:B. Kovács Judit Lőrincz Margit Gorácz Gyula Szabados Katalin Balogh Márta
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