Résumé
OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which leads to an immunemediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. São Paulo city is one of the largest cities in the world, with a vast population and an important history of internal migratory flow from other Brazilian regions, as well as immigration from other, primarily European, countries, resulting in significant miscegenation. The aim of the present study was to estimate the prevalence of adults with undiagnosed celiac disease among blood donors of São Paulo by collecting information on the ancestry of the population studied. METHODS: The prevalence of celiac disease was assessed by screening for positive IgA transglutaminase and IgA endomysium antibodies in 4,000 donors (volunteers) in the Fundação Pró-Sangue Blood Center of São Paulo, São Paulo, Brazil. The antibody-positive subjects were asked to undergo a small bowel biopsy. RESULTS: Of the 4,000 subjects, twenty-four had positive tests, although both antibody tests were not always concordant. For example, ten subjects were positive for IgA tissue transglutaminase only. In twenty-one positive patients, duodenal biopsies were performed, and the diagnosis of celiac disease was confirmed in fourteen patients (Marsh criteria modified by Oberhuber). In this group, 67% claimed to have European ancestry, mainly from Italy, Portugal and Spain. CONCLUSION: The prevalence of celiac disease is at least 1:286 among supposedly healthy blood bank volunteers in São Paulo, Brazil.
Sujets)
Adolescent , Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Donneurs de sang/statistiques et données numériques , Maladie coeliaque/épidémiologie , Banques de sang , Brésil/épidémiologie , Maladie coeliaque/ethnologie , Villes/épidémiologie , /statistiques et données numériques , Méthodes épidémiologiques , Immunoglobuline A/sang , Transglutaminases/sangRésumé
O objetivo dessa pesquisa visou estimar a prevalência da Doença Celíaca em adultos na cidade de São Paulo e correlacionou essa prevalência com a etnia da população estudada.Foram realizados testes sorológicos anti-transglutaminase IgA e anti-endomísio IgA em 4.000 doadores de sangue...
The aim of the present study was to assess the prevalence of unrecognized adult celiac disease in Sao Paulo and correlate it with further information about ancestry of the population studied. We have measured the prevalence of celiac disease by means of a survey of serum markers (IgA transglutaminase antibody and IgA endomysium antibody) in 4,000 donors in the central Blood Bank in Sao Paulo. The antibody-positive subjects were asked to undergo small bowel biopsy. Of the 4,000 subjects, twenty-four had positive tests. States and Europe.
Sujets)
Humains , Mâle , Femelle , Adolescent , Adulte , Adulte d'âge moyen , Maladie coeliaque/diagnostic , Santé des Minorités Ethniques , Biopsie , Maladie coeliaque/épidémiologie , Maladie coeliaque/anatomopathologie , Tests sérologiquesRésumé
Trinta casos de pacientes com calazar foram diagnosticados mediante biópsia de crista ilíaca e mielo-cultura. Após estudo histológico 12 apresentavam espessamento difuso da rede de reticulina. Pelo que foi possível resgatar na literatura, apenas dois relatos descrevem uma fibrose medular difusa (como mielofibrose) secundária ao calazar humano. Näo foi encontrada diferença significativa nos parâmetros clínico-laboratoriais (hepatoesplenomegalia, hematócrifo, hemograma, plaquetas e proteínas séricas), havendo tendência semelhante à regressäo da hepato-esplenomegalia e melhora dos parâmetros laboratoriais nos dois grupos (com e sem fibrose medular difusa). Os dados permitem inferir que tal fibrose pode ser transitória näo interferindo na evoluçäo ou na resposta ao glucantime