Asemptomatik bireylerde gluten sensitif enteropati seroprevalansi
The prevalance of glutene sensitive enteropathy in asymptomatic person
SSK Samsun Bölge Hastanesi, Biyokimya Klinigi2, Istanbul
Özet
Giris ve amaç: Gluten sensitif enteropati bazi tahil ürünlerinin diyetle alimi sonucu malabsorbsiyon tablosunun gelistigi otoimmun ve familyal özellikli bir hastaliktir. Bugday, arpa ve çavdarin içerdigi bitkisel protein glutene karsi ömür boyu süren intoleransla karakterizedir. Bu çalismada ishal ve karin agrisi gibi semptomlar tarif etmeyen ve baska herhangi bir sistemik hastaligi olmayan bireylerde antikor pozitifligi taranarak Gluten Sensitif Enteropati’nin Türk toplumundaki seroprevalansi arasti- rildi. Gereç ve yöntem: Çalismaya 2002-2004 yillari arasinda genel dahiliye poliklinigine ayaktan basvuran ve bilinen herhangi bir sistemik hastaligi olmayan 255 kadin, 150 erkek toplam 405 kisi alindi. Çalismaya dahil edilen tüm bireylerin yas araligi 15-95, yas ortalamasi 45,7 idi. Bu bireylerde Gluten Sensitif Enteropati taramasinda yüksek spesifite ve sensitiviteye sahip olan anti endomisyum IgA antikoru (anti-EMA) immunfloresans yöntemi ile çalisildi. Bulgular: Çalismaya alinan 405 kisiden sadece 19 yasinda bir erkekte EMA pozitifligi tespit edildi. (seroprevalans: 0,002 p< 0,001) Sonuç: Çalismanin sonucu olarak ülkemizde, Gluten Sensitif Enteropati'nin Bati toplumlarina göre nadir görülen bir klinik tablo oldugu söylenebilir.
Abstract
Background/aim: Gluten-sensitive enteropathy is an autoimmune and familial illness that develops after malabsorption, which is due to dietary intake of some grain products. It is characterized by life-long intolerance to gluten protein, which is found in wheat, rye, and barley. In this study, seroprevalence of asymptomatic gluten-sensitive enteropathy in the Turk›sh community was explored by investigating positivity and antibody in individuals who have no systemic illness and no symptoms such as diarrhea and abdominal pain. Materials and methods: 405 individuals without any known systemic illness were followed as outpatients between 2002-2004. Mean age was 45.7, range 15-95 years old. Anti- endomysium antibodies (anti EMA) were studied with immunofluorescence assay, which has a high specificity and sensitivity for screening gluten-sensitive enteropathy. Results: Antibody positivity was determined in only one 19-year-old boy among the 405 cases, and seroprevalence as 0.002, p<0.001. Conclusion: The results of this study suggest that gluten-sensitive enteropathy is a rare clinical problem in our country compared to western society.
