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Zöliakie

Celiac disease

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Der Gastroenterologe Aims and scope

Zusammenfassung

Die Zöliakie ist eine immunogene systemische Entzündung, die durch Gluten oder verwandte Getreidebestandteile in genetisch prädisponierten Individuen entsteht. Sie ist diagnostisch durch 4 Kriterien charakterisiert: 1. gastrointestinale (malabsorptive) und/oder extraintestinale Symptomatik, 2. Nachweis des Transglutaminase-2- bzw. Endomysiumantikörpers, 3. Positivität für HLA-DQ2/8, 4. bioptischer Nachweis einer Marsh-II/III-Läsion in der duodenalen Mukosa. Entsprechend den neuen Kriterien der European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) von 2011 erlauben die hohe Spezifität und Sensitivität des Transglutaminase- bzw. Endomysiumantikörpers unter bestimmten Bedingungen (inkl. Positivität von HLA-DQ2/8), auf die Durchführung einer duodenalen Biopsie zur Sicherung der Zöliakiediagnose zu verzichten. Die einzige derzeit verfügbare Therapie der Zöliakie ist die glutenfreie Diät, die eine strikte und lebenslange Einhaltung erfordert und zur Verhinderung von akuten und langfristigen Komplikationen sehr wirksam und gleichzeitig nebenwirkungsfrei ist.

Abstract

Celiac disease is an immunogenic systemic inflammation, which is induced by gluten and related cereals in genetically susceptible individuals. There are four diagnostic criteria of celiac disease: 1) gastrointestinal and/or extraintestinal symptoms, 2) detection of tissue transglutaminase 2 or endomysium antibody, 3) positivity for HLA-DQ2/8 and 4) demonstration of a Marsh II/III lesion in the duodenal mucosa. According to the new criteria of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) from 2011 the high sensitivity and specificity of transglutaminase or endomysium antibodies allow under distinct conditions (including positivity of HLA-DQ2/8) celiac disease to be diagnosed without the performance of a duodenal biopsy. The only available therapy of celiac disease is a gluten-free diet, which requires a strict and lifelong adherence to prevent acute and late complications of the disease and is very effective and free from side-effects.

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  1. Abt. Allgemeine Pädiatrie und Neonatologie, Zentrum für Kinderheilkunde und Jugendmedizin, Justus-Liebig-Universität, Feulgenstr. 12, 35385, Gießen, Deutschland

    K.-P. Zimmer

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Zimmer, KP. Zöliakie. Gastroenterologe 6, 471–476 (2011). https://doi.org/10.1007/s11377-010-0512-y

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