revisione critica dei criteri diagnostici espghan 2012 … · espghan 2012 per la diagnosi di...
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Francesco Valitutti
UOC Gastroenterologia ed Epatologia Pediatrica
Policlinico Umberto I
Dipartimento di Pediatria e Neuropsichiatria Infantile,
Sapienza Università di Roma
Direttore: Prof. Salvatore Cucchiara
REVISIONE CRITICA DEI CRITERI DIAGNOSTICI
ESPGHAN 2012 PER LA DIAGNOSI DI CELIACHIA
Roma, 01.03.14
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Diagnosis CD
Biopsy -Centred
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Metodologia
Creazione dell’ESPGHAN working group dedicato
(2007)
Revisione della letteratura sulla diagnosi di celiachia
negli ultimi decenni
Grades of evidence/ strenght of reccomendation
Voting system
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Definition of CD: 2012
CD is a immune-mediaded systemic disorder
elicited by gluten and related prolamines in
genetically susceptible individuals, charactericed
by the presence of variable combination of gluten
dependent clinical manifestation, CD specific
antibodies, HLA DQ2 and DQ8 haplotypes and
enteropathy.
JPGN 2012; 54:136-60.
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Take home messages
Possibile omissione della biopsia in casi selezionati
pediatrici (sintomi suggestivi, anti-tTg>10ULN, EMA
pos, HLADQ2 e/o DQ8)
Applicazione esclusivamente nei centri di
gastroenterologia pediatrica di riferimento
Validazione in progress
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Non-biopsy diagnosis of CD can be likened to
the young child who asks his parents shortly
after starting a long journey ‘‘are we nearly
there yet?’’ The answer is ‘‘there is still a long
way to go but we are headed in the right
direction.’’
Ivor D. Hill and Karoly Horvath