[Positive tests for serum anti-endomysium antibodies (AEA) and anti-jejunal antibodies (JAB) and histopathological diagnosis of celiac disease in children]. / Pozitivita sérových protilátok proti endomýziu, jejunu a histopatologická diagnostika celiakie u detí.

Non-invasive examination methods are increasingly important in diagnosing celiac disease. New options for diagnosing celiac disease have been discovered in addition to the established biochemical, hematological and other methods as a result expansive progress ofclinical genetics and immunology. At the same time, detection of circulating auto-antibodies is becoming ever more frequent in clinical practice. As a result, many new, clinically highly heterogeneous cases of the disease have been diagnosed and consequently the prevalence of the disease in both child and adult population has grown. Detection of anti-endomysial antibodies (AEA), characteristic for their high sensitivity and specificity, plays an important role in diagnosing and monitoring celiac disease in pediatric practice. Nevertheless, histopathological diagnosis remains the critical tool for definitive diagnosis of the disease. The article refers to relations between the degree of positivity of AEA and JAB antibodies in the IgA class and the respective grade in the Marsh grading system. The objective of the study was to examine AEA and JAB antibodies and the histological picture of the duodenal mucosa in 20 children and adolescents with celiac disease aged from 2 to 18 years. The authors developed a semiquantitative scale of positivity of both the antibodies, which they compared trying to find a correlation between these and the histopathological picture of the duodenal mucosa. The authors point out the need of timely determination of AEA and t-TG (tissue transglutaminase) in patients whose anamnesis, clinical picture or laboratory results may be indicative of celiac disease.

[Histopathological diagnosis of celiac disease in adults with functional dyspeptic syndrome]. / Histopatologická diagnostika celiakie u dospelých s funkcným dyspeptickým syndrómom.

Celiac disease is associated with permanent intolerance to gluten, which is found in some cereals. The symptoms of the disease are often nonconspicuous and the course of the disease is atypical. With the introduction of serological markers as a sensitive method of testing new cases of the disease were identified. Despite of the increased screening intensity among children and adults celiac disease in our region is still underdiagnosed. The article deals with the diagnostics of celiac disease in adults with functional dyspeptic syndrome. It is based on the laboratory and pathological correlation of 25 patients. Our aim was to identify the group at risk with functional dyspeptic syndrome and celiac disease. This disease can show symptoms from the onset all the way to relapse. Each person was examined by a gastroenterologist while hospitalized in the relevant department. In addition to the routine serological testing, blood samples were taken and sent for antiendomyzial antibody testing for positive reaction verification. A subsequent gastrointestinal examination was done and samples taken from the duodenum were sent for histology. Light microscopy analysis showed mucous damage typical for celiac disease, which is expressed with the levels of the Marsh histological grading. In closing, we recommend a three-step approach to goal-oriented screening of celiac disease. Determination of autoantibody against tissue transglutaminase, if positive, then biopsy from the aboral duodenum, and consequently follow-up by testing for antiendomyzial antibody.