0872-8178 0872-8178 S0872-81782006000300003 Portugal Portugal 00 05 2006 00 05 2006 13 3 139 143

Doença celíaca no adulto: a propósito de um caso clínico

A. Sousa Machado1, A. Vasconcelos Teixeira1, H. Cardoso1, D. Cruz2, M. E. Paiva2, F. Tavarela-Veloso1

 

Resumo

Os autores apresentam o caso clínico de um doente do sexo masculino, caucasiano, com 20 anos de idade, sem antecedentes patológicos ou familiares de relevo, com história de diarreia crónica, dores articulares e emagrecimento. A avaliação laboratorial revelou alterações sugestivas de má absorção. Foi diagnosticada doença celíaca com base em achados serológicos, endoscópicos e histológicos. A instituição de dieta sem glúten acompanhou-se de recuperação do estado geral e correcção das alterações analíticas.

 

Summary

The authors present the case of a 20 year old male Caucasian with no relevant personal or family history of disease, who presented with a history of diarrhoea, joint pain and weight loss. Laboratory findings pointed to malabsorption. Celiac disease was diagnosed based on endoscopic, histological and serological findings. He gradually recovered both clinically and in terms of laboratory values, after being started on a gluten-free diet.

 

Texto Completo disponível apenas em PDF

]]> Full text only available in PDF format

 

 

Bibliografia

1. Farrel RJ, Kelly CP. Celiac Sprue. N Engl J Med 2002; 346 (3):180-7.        [ Links ]

2. Booth CC. History of celiac disease. BMJ 1989; 298: 527-36.

3. Dicke WK. Simple dietary treatment of the syndrome of GheeHerter. Ned Tijdschr Geneeskd 1941; 85: 1715.

4. Dicke WK, Van de Kamer JH, Weyers HA. Celiac disease II. The presence in wheat of a factor having a deleterious effect in cases of celiac disease. Acta Paediatr 1953; 42: 34-42.

5. Van de Kamer JH, Weyers HA, Dicke WK. Coeliac disease IV. An investigation into the injurious constituents of wheat in connection with their action on patients with coeliac disease. Acta Paediatr 1953; 42: 223-31.

6. Paulley LW. Observations on the aetiology of idiopathic steatorrhoea. Br Med J 1954; 2: 1318-21.

7. Fasano A. Where have all the American celiacs gone?. Acta Paediatr Suppl 1996; 412: 20-4.

]]> 8. Not T, Horvath K, Hill ID. Celiac disease risk in USA: High prevalence of antiendomysium antibodies in healthy blood donors. Scand J Gastroenterol 1998; 33: 494-8.

9. Ascher H, Kristiansson B. Childhood coeliac disease in sweden. Lancet 1994; 344: 340-1.

10. Marsh MN. Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity. Gastroenterology 1992;102: 330-54.

11. OLeary C, Wieneke P, Buckley S. Celiac disease and irritable bowel-type symptoms. Am J Gastroenterol 2002; 97: 1463-7.

12. Bottaro G, Cataldo F, Rotolo N. The clinical pattern of subclinical silent celiac disease: An analysis on 1026 consecutive cases. Am J Gastroenterol 1999; 94: 691-6.

13. Kagnoff MF. Celiac Disease. A gastrointestinal disease with environmental, genetic and immunologic components. Gastroenterol Clin North Am 1992; 21: 405-25.

14. Schuppan D. Current concepts of celiac disease pathogenesis. Gastroenterology 2000; 119: 234-43.

15. Ferreira M, Davies Sl, Butler M. Endomysial antibody: Is it the best screening test for coeliac disease?. Gut 1992; 33:1633-7.

16. Unsworth DJ, Brown DL. Serological screening suggests that adult coeliac disease is underdiagnosed in the UK and increases yhe incidence by up to 12 percent. Gut 1994; 35: 61-4.

17. Holmes GK. Non-malignant complications of celiac disease. Acta Paediatr Suppl 1996; 412: 68-75.

]]> 18. Addolorato G, Stefanini GF, Capristo E. Anxiety and depression in adult untreated celiac subjects and in patients affected by inflamatory disease: A personality "trait" or a reactive illness?. Hepatogastroenterology 1996; 43: 1513-7.

19. Hadjivassiliou M, Chattopadhyay AK, Davies-Jones GA. Neuromuscular disorder as a presenting feature of celiac disease. J Neurol Neurosurg Psychiatry 1997; 63: 770-5.

20. Hadjivassiliou M, Gibson A, Davies-Jones GA. Is cryptic gluten sensitivity an important cause of neurologic illness?. Lancet 1996; 347: 369-71.

21. West J, Logan Rf, Card TR. Fracture risk in people with celiac disease: A population-based cohort study. Gastroenterology 2003; 125: 429-36.

22. Schmitz F, Herzig KH, Stuber E. On the pathogenesis and clinical course of mesenteric lymph node cavitation and hyposplenism in celiac disease. Int J Colorectal Dis 2002; 17:192-8.

23. Johnston SD, Robinson J. Fatal pneumococcal septicaemia in a celiac patient. Eur J Gastroenterol Hepatol 1998; 10: 353-4.

24. Logan Rf, Rifkind EA, Turner ID, Ferguson A. Mortality in celiac disease. Gastroenterology 1989; 97: 265-71.

25. Corrao G, Corazza GR, Bagnardi V. Mortality in patients with celiac disease and their relatives: a cohort study. Lancet 2001;358: 356-61.

26. Ventura A, Magazzu G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. Gastroenterology 1999; 117: 297- 303.

27. Norgard B, Fonager K, Sorensen HT, Olsen J. Birth outcomes of women with celiac disease: A nationwide historical cohort study. Am J Gastroenterol 1999; 94: 2435-40.

]]> 28. Tursi A, Brandimarte G, Giorgetti G. Lack of usefulness of anti-transglutaminase antibodies in Assessing histologic recovery after gluten-free diet in celiac disease. Journal of Clinical Gastrenterology 2003; 37: 387-391.

 

(1) Serviço de Gastrenterologia do Hospital de São João, Porto, Portugal.

(2) Serviço de Anatomia Patológica do Hospital de São João, Porto, Portugal.

 

Recebido para publicação: 22/03/2005

Aceite para publicação: 22/02/2006

]]> 2002 346 3 3 180-7