Background: Celiac disease is an enteropathy characterized by gluten sensitivity and broad
clinical aspect. Has a multifactorial cause and depends on genetic, immunological
and environmental factors for its development. The genetic influence is given
mostly by the human leukocyte antigens HLA DQ2 and DQ8. Aim: To evaluate the prevalence of human leukocyte antigens DQ2 and DQ8 in three
different groups: patients with celiac disease, first-degree relatives and the
general population. Method: Retrospective analysis that evaluated serologic and endoscopic data of 74 patients
with celiac disease and 109 non-celiac, which were subdivided into two subgroups:
non-celiac who had first-degree relatives with celiac and non-celiac who did not.
All patients underwent laboratory examination for screening genetic sensitivity
given by HLA DQ2 and HLA DQ8 by. Results: The presence of HLA DQ2 and DQ8 was identified in 98,4% of 74 celiac patients, of
which 79,7% had only HLA DQ2; 8,1% had only HLA DQ8 and 10,8% had both antigens
histocompatibility. In the group of relatives of celiac patients, were included 29
patients; among them, 89,6% had HLA DQ2 and/or DQ8; 76% only the HLA DQ2, 10,3%
only HLA DQ8 and 3,4% presented both human leukocyte antigens (HLA). Conclusion: HLA DQ2/DQ8 was present in 98,4% of celiac patients; 89,6% relatives of celiac
family and in 55,4% of people from the general population without family
celiac.
BackgroundIn patients with chronic diarrhea, colonoscopy may identify inflammatory causes or
some occult disease, and also can show a normal mucosa. Serial biopsies of
intestinal mucosa can be useful for a differential diagnosis, and to modify the
treatment.AimTo evaluate whether the biopsies performed in patients with chronic diarrhea and a
normal colonoscopy contribute to the differential diagnosis and alter the
therapeutic approach.MethodsA descriptive, retrospective and cross-sectional study using a computerized
database was done. Patients with chronic diarrhea and a normal
colonoscopy underwent serial biopsies of the terminal ileum, ascending colon and
rectum.ResultsFrom 398 records, 214 were excluded. Of the 184 patients enrolled, 91 showed
histological changes: 40% nonspecific inflammation; 5.18% lymphocytic
inflammation, 10.37% eosinophilic inflammation; 39.26% lymphoid hyperplasia; 2.22%
collagenous colitis; 2.22% melanosis; and 0.74% pseudomelanose. The sites with the
largest number of changes were the terminal ileum and right colon.ConclusionsSerial biopsies in patients with chronic diarrhea and normal colonoscopy
identified changes in almost 50% of cases and 22% of these cases may had modified
the treatment after identification of collagenous, lymphocytic and eosinophilic
colitis.
The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.
Background and study aims: Celiac disease (CD) is a chronic systemic autoimmune disorder affecting genetically predisposed individuals, triggered and maintained by the ingestion of gluten. Triggered and maintained by the ingestion of gluten, celiac disease is a chronic systemic autoimmune disorder affecting genetically predisposed individuals. Persistent related inflammation of the duodenal mucosa causes atrophy architecture detectable on esophagogastroduodenoscopy (EGD) and histopathology. We investigated the association between endoscopic features and histopathological findings (Marsh) for duodenal mucosa in celiac disease patients and propose an endoscopic classification of severity.
Patients and methods: Between January 2000 and March 2010, an electronic database containing 34,540 EDGs of patients aged > 14 years was searched for cases of CD. Out of 109 cases, 85 met the inclusion criteria: conventional EGD combined with chromoendoscopy, zoom and biopsy. EGD types 0, I and II corresponds to Marsh grades 0, 1 and 2, respectively, while EGD type III corresponds to Marsh grade 3 and 4.
Results: Five patients (5.8 %) were EGD I but not Marsh grade 1; 25 patients (29.4 %) were EGD II, 4 of whom (16 %) were classified as Marsh grade 2; and 55 patients (64.7 %) were EGD III, 51 (92.7 %) of whom were classified as Marsh grades 3 and 4. The Spearman correlation coefficient (r = 0.33) revealed a significant association between the methods (P = 0.002).
Conclusions: Changes in the duodenal mucosa detected on EGD were significantly and positively associated with histopathologic findings. The use of chromoendoscopy in addition to conventional EGD enhances changes in the duodenal mucosa and permits diagnosis of CD, even in routine examinations. The proposed endoscopic classification is practical and easily reproducible and provides valuable information regarding disease extension.
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