Saturday, October 17, 2009

Breakfasts With Buster

Celiachia: in aumento le diagnosi errate

Professor Umberto Volta , Chairman of the Scientific Committee of micr AIC (Italian Celiac Association), in recent times, is raising the problem of misdiagnosis of Celiac [1] .

In short, on the one hand, the Celiac disease is a diagnosis that doctors are very many still consider the other, it appears that many diagnoses of celiac disease are not really correct.

This would involve other diseases.

For those involved in autoimmune disease, is not new: such diseases, by their nature, are generally easy to diagnose. We must in fact have considerable experience to make a diagnosis called "differential".

Let's see, in short, why.

First, not you can be sure if the disease is only part of the remission of symptoms after gluten-free diet.

One of the biggest mistakes you can commit is the exclusion of gluten-free "testing." Many conditions can benefit from the elimination of gluten which, remember, is a food and glue can be difficult to digest.

As we know, there are other diseases in which doctors prefer to exclude (if only to caution) gluten, but these are forms of celiac disease.

Another problem is that the flattening of the villi. Not only does the Celiac causes. But antibiotics intestinal infections or other diseases.

In conclusion, the diagnosis should be carried out by hospitals or facilities that are able to actually see if it comes to Celiac Disease or other diseases.

This is done either through knowledge of the diagnostic protocol, is counting on being inclusive, it is also essential to know the symptoms or non-standard situations, such as extra-intestinal symptoms with celiac disease or celiac disease sero-negative.

However, with proper precautions, I would emphasize two aspects.

The first is that to exclude celiac disease does NOT mean leaving the patient without a diagnosis, which unfortunately often happens. E ' molto frequente infatti, che il paziente venga semplicemente informato che non si tratta di Celiachia, ma l’indagine si conclude lì, senza che si ricerchi la vera causa.

Il secondo è che la ricerca in questo ambito dovrebbe, a mio parere, scoprire se esistono forme della Malattia Celiachia che NON sono ancora identificabili tramite l’applicazione rigorosa del protocollo diagnostico.

Già ora siamo in grado di identificare casi cosiddetti “border-line”, ovvero che non sono contemplati nel diagramma di flusso relativo all’iter diagnostico proposto nel protocollo [2] .

Pensiamo ad esempio, ai casi relativi ai celiaci HLA negativi. If you experience a screening of first degree relatives of celiac disease patients based only on genetic predisposition, the protocol we would exclude the possibility, in principle, subject to other controls on HLA negative.

The data so far known, people with celiac disease were HLA negative 9% of the total population celiac, if we look at the figures in this way does not seem like much, but we're still talking about 9 of every 100 people.

Practically, 1 in 10 people.

[1] http://www.corriere.it/salute/nutrizione/09_ottobre_16/pastiglia-anti-celiachia_23ccfd52-b8ae-11de-9ba8-00144f02aabc.shtml

[2] http://www.celiachia.it/aic/res/doc/delib_20_12_2007.pdf

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