The Relationship Between Gluten Enteropathy and Nail Capileroscopy Findings and Disease Activation

Yıl 2022, Cilt: 12 Sayı: 3, 760 - 764, 28.09.2022

Burak Okyar , Abdullah Emre Yıldırım , Sezgin Barutçu

https://doi.org/10.33808/clinexphealthsci.1022573

Öz

Objective: Nailfold Videocapilloroscopy (NVC) is an examination method that is used as an aid in the diagnosis, follow-up, and treatment strategy of rheumatic diseases such as systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, and gives an idea about microcirculation by examining the vascular bed. It is a cheap, easily applicable, and quickly accessible method. Because of these features, we aimed to use the NVC method in patients with Gluten Enteropathy (GE) to determine whether this method will be a helpful technique in the diagnosis, activation decision, remission follow-up, and treatment strategy in patients with GE.

Methods: In this study, 67 patients diagnosed with GE (n=35 disease-active group (AGE), n=32 disease-related remission group (RGE), and control group (CG)-27 healthy people whose diagnosis of GE was ruled out were included in this study. Group and CG were divided into ten parameters in capillary pathologies (capillary density loss, dilated capillary, giant capillary, microhemorrhage, avascular area, tortuosity, branched capillary, disorganization, extravasation, angiogenesis). They were divided into two groups as RGE and compared with the results obtained from NVC measurements

Results: When patients diagnosed with GE and CG were evaluated in terms of capillary disorder with NVC, While all of the patients with capillary disorders were in the GE group, no capillary disorders were found in the control group (p<0.01). When patients diagnosed with GE were divided into two groups (AGE and RGE), NVC measurements were compared; All patients with capillary disorders were found in the AGE group (p<0.01). Capillary density loss and/or avascular area were detected in 80.9% of patients with capillary disorders.

Conclucion: Our study found a statistically significant difference in NVC measurements between GE patients and CG (p<0.01). The fact that all patients with capillary disorders were in the active group in terms of the disease and no capillary disorders were detected in any patients in remission showed that this method could be used as an auxiliary technique in the diagnosis of GE, making the decision of activation or remission, monitoring the disease and determining treatment strategies.

Anahtar Kelimeler

CELİAC DİSEASE, VİDEO CAPİLLEROSCOPY, GLUTEN ENTHEROPATHY

Kaynakça

• [1] Mearin ML. Celiac disease among children and adolescents. Curr Probl Pediatr Adolesc Health Care 2007;37:86-105.
• [2] Rodrigo L. Celiac disease. World J Gastroenterol. 2006 Nov 7;12(41):6585-93. doi: 10.3748/wjg.v12.i41.6585.
• [3] Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for standardized report schema for pathologists. Eur J Gastroenterol Hepatol 1999; 11: 1185-94.
• [4] Guyton H. Basic physiology book (Trans. Ed. Çavuşoğlu). Nobel Medical Bookstores, Tenth Edition, 162-182.
• [5] Korponay-Szabó I.R., Halttunen T., Szalai Z., Laurila K., Király R., Kovács J.B., Fésüs L., Mäki M. In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies. Gut 2004;53:641–648.
• [6] Iltanen S, Collin P, Korpela M, Holm K. Celiac disease and markers of celiac disease latency in patients with primary Sjogren’s syndrome. Am. J. Gastroenterol. 1999;94:1042– 1046.
• [7] Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for standardized report schema for pathologists. Eur J Gastroenterol Hepatol 1999; 11: 1185-1194.
• [8] Ensari A. Gluten-sensitive enteropathy (Celiac Disease) controversies in diagnosis and classification. Arch Pathol Lab Med 2010; 134: 826-836.
• [9] Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Naillfold capillaroscopy in rheumatic diseases: Which parameters should be evalutes? Hindawi Publishing Corporation BioMed Research International 2015;974530.
• [10] Cutolo M, Pizzorni C, Secchi ME, Sulli A. Capillaroscopy. Best Pract Res Clin Rheumatol. 2008;22(6):1093-108.
• [11] Ventura A, Magazzù G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. Gastroenterology 1999; 117: 297-303.
• [12] Maki M, Lohi O. Celiac Disease. In: Walker WA, Goulet O, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR (eds). Pediatric Gastrointestinal Disease. 4th ed. Ontario: B.C. Decker, 2004: 932-43
• [13] Molberg O, McAdam S, Lundin KE, Kristiansen C, Arentz- Hansen H, Kett K, Sollid LM. T cells from celiac disease lesions recognize gliadin epitopes deamidated in situ by endogenous tis – sue transglutaminase. Eur J Immunol 2001; 31: 1317- 1323.
• [14] Cataldo F, Marino V, Ventura A, Bottaro G, Corazza GR. Prevalence and clinical features of selective immunoglobulin A deficiency in coeliac disease: an Italian multicentre study. Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP) and “Club del Tenue” Working Groups on Coeliac Disease. Gut 1998;42:362-365.
• [15] Thonhofer R, Trummer M, Siegel C. Capillaroscopy shows an active pattern of scleroderma in coeliac disease. Scand J Rheumatol. 2010;39(5):438-439.