[Histopathological diagnosis of celiac disease in adults with functional dyspeptic syndrome]

Celiac disease is associated with permanent intolerance to gluten, which is found in some cereals. The symptoms of the disease are often nonconspicuous and the course of the disease is atypical. With the introduction of serological markers as a sensitive method of testing new cases of the disease were identified. Despite of the increased screening intensity among children and adults celiac disease in our region is still underdiagnosed. The article deals with the diagnostics of celiac disease in adults with functional dyspeptic syndrome. It is based on the laboratory and pathological correlation of 25 patients. Our aim was to identify the group at risk with functional dyspeptic syndrome and celiac disease. This disease can show symptoms from the onset all the way to relapse. Each person was examined by a gastroenterologist while hospitalized in the relevant department. In addition to the routine serological testing, blood samples were taken and sent for antiendomyzial antibody testing for positive reaction verification. A subsequent gastrointestinal examination was done and samples taken from the duodenum were sent for histology. Light microscopy analysis showed mucous damage typical for celiac disease, which is expressed with the levels of the Marsh histological grading. In closing, we recommend a three-step approach to goal-oriented screening of celiac disease. Determination of autoantibody against tissue transglutaminase, if positive, then biopsy from the aboral duodenum, and consequently follow-up by testing for antiendomyzial antibody.