Celiachia: quanto è comune in medicina di base?
Inserito da redazione il Gio, 17/07/2008 - 18:28
in
Secondo uno studio prospettico di coorte la celiachia sarebbe una condizione relativamente comune nella popolazione che frequenta gli ambulatori dei medici di Medicina Generale.
In questo studio prospettico di coorte sono stati selezionati tutti i pazienti che afferivano a medici di Medicina Generale e che lamentavano disturbi di tipo digestivo oppure avevano una comorbidità che si conosce essere spesso associata alla celiachia (anamensi positiva per celiachia, anemia, dolore addominale ricorrente o gonfiore addominale, colon irritabile, diarrea cronica, fatica cronica, malattie autoimmuni). A questi pazienti venne chiesto se erano disposti a partecipare allo studio, che prevedeva la compilazione di un questionario dettagliato e l'esecuzione di un esame ematico per lo screening della celiachia. Su 2.568 pazienti a cui venne chiesto di partecipare il 33% non aveva nessun sintomo che potesse far sospettare una celiachia, il 3% rifiutò di compilare il questionario e il 26% rifiutò l'accertamento di laboratorio.
Ai rimanenti 976 pazienti furono dosati gli anticorpi anti-transglutaminasi IgA. Si trovò un titolo elevato in 30 pazienti; a questi vennero dosati gli anticorpi IgA anti-endomisio, che risultò alterato in 22 casi.
Di questi ultimi, 15 si sottoposero a biopsia digiunale e 17 adottarono una dieta priva di glutine.
In conclusione la celiachia venne diagnosticato ogni 11,6 casi per mille visite. Gli autori concludono che la celiachia, nella popolazione generale, è molto più frequente di quanto non si creda comunemente.
Fonte:
Catassi C et al. Detection of celiac disease in primary care: a multicenter case-finding study in North America. Am J Gastroenterol 2007;102:1454-1460.
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