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• W1989569422 abstract "Celiac disease is an autoimmune enteropathy induced by the gluten in genetically predisposed individuals. The production of the autoantibodies in the disease is a result of recognition by the immune system of tissue transglutaminase combined with the gliadin, inducing antibodies (ab) that are specific to celiac disease such as antigliadin (AGA), anti-endomysium (EMA) and antitissue transglutaminase (tTGA) antibodies. The children with CD may primarily show atypical or silent clinical forms with extradigestive symptoms, leading to delay of diagnosis and expose patients to serious complications. AGA, EMA and tTGA permit to identify patients for whom intestinal biopsy is recommended, to detect children running the risk of celiac disease and to assess the adherence to gluten free diet. Despite the need of an histological proof to confirm the disease, serologic tests have a great value in screening and diagnosing CD. To diagnose CD, it is recommended to initially seek for IgA tTGA isotypes, provided ruling out an IgA deficiency, mostly associated to CD. This first step should be followed by EMA test; which is a highly specific marker of the disease. The tTGA test for whom performances are relatively as good as those of EMA test is currently supplanting AGA test for the screening of the CD. It also represents an adequate tool for the follow-up of children under gluten free diet. La maladie cœliaque (MC) est une entéropathie auto-immune induite par le gluten alimentaire chez des sujets génétiquement prédisposés. La production d’autoanticorps au cours de la MC serait secondaire à la reconnaissance par le système immunitaire de la transglutaminase complexée à la gliadine, induisant des anticorps (Ac) spécifiques de la maladie : Ac antigliadine (AGA), anti-endomysium (EMA) et anti-transglutaminase tissulaire (tTGA). Les enfants cœliaques peuvent présenter essentiellement des formes cliniques atypiques ou silencieuses de la maladie, avec des symptômes extradigestifs fréquents, conduisant au retard diagnostique et exposant les malades à de complications parfois graves. En dépit de la nécessité d’une preuve histologique pour confirmer la maladie, les tests sérologiques constituent des outils de dépistage et de diagnostic de grande valeur. Ils permettent d’identifier les patients pour lesquels la biopsie intestinale est indiquée, de dépister les enfants à risque et d’évaluer l’adhésion au régime sans gluten. La démarche du diagnostic immunologique repose actuellement sur la recherche initiale des tTGA d’isotype IgA, puis lorsque positifs, des EMA, marqueurs hautement spécifiques de la maladie. Il est cependant nécessaire d’éliminer un déficit sélectif en IgA, fréquent au cours de la MC. Les Ac anti-tTG, dont la sensibilité et la spécificité sont relativement comparables à celles des EMA, ont tendance à supplanter les AGA pour le dépistage de la MC. Ils sont également plus appropriés pour le suivi des enfants sous régime sans gluten." @default.
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• W1989569422 date "2009-08-01" @default.
• W1989569422 modified "2023-10-14" @default.
• W1989569422 title "Diagnostic immunologique de la maladie cœliaque chez l’enfant. Mise au point" @default.
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• W1989569422 doi "https://doi.org/10.1016/j.immbio.2009.06.005" @default.
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