Abstract

NOGALES, Andrea et al. PATTERNS IN CLINICAL PRESENTATIONS, SEROLOGY SENSITIVITY IN FRONT OF HISTOLOGY IN THE CHILDREN CELIACS HLA DQ2/DQ8. Gen [online]. 2015, vol.69, n.2, pp.45-49. ISSN 0016-3503.

Introduction: In tropical areas where the differential diag- nosis for celiac disease is present, the determination of HLA DQ2/DQ8 is useful to confirm the existence of the disease in symptomatic patients or HIV negative and positive mucosal injury and mucosal antibody or normal with limiting the high cost. Objective: To determine the clinical pattern in celiac children with HLA determination DQ2/DQ8 and investigate the sensitivity of the serology screening histology in the diagnosis of disease. Patients and methods: Prospective, cross-sectional, which included 18 children with celiac DQ2/ DQ8 determination. Was recorded: age, sex, clinical, sero- logy, biopsy and genetics. Results: mean age 3.39 years (8m-13), 55.55% females. Classic clinical pattern in 12/18 (66.67%), atypical 3/18 (16.67%), latent 2/18 (11.11%), potential 1/18 (5.55%). In total 12/18 patients (66.67%) with positive serology. A histology: 2/18 normal mucosa (11.11%) and 16/18 altered (88.89%), of whom 4 Marsh I, 5 Marsh II, 7 Marsh III. In all children with positive serology bowel injury was observed, 25% villus atrophy. With negative serology, 4 with villous atrophy (2/4 with IgA deficiency) and 2 normal mucosa. We found a sensitivity of serology for diagnosis in 75%, specificity 100%. 77.77% diagnostic accuracy of serology against histology. Conclusions: resulted serology with acceptable sensitivity for the screening and diagnosis of celiac HLA determining DQ2/DQ8 was useful in characterizing the clinical pattern and disease detection a group of patients in characterizing the clinical pattern and detection of the disease a group of patients.

Keywords : celiac disease; HLA DQ2/DQ8; villous atrophy; serology; Marsh criteria.