Isinyathelo Sokuqala Ekutholeni
Ukuhlolwa kwesifo se-celiac cishe kuqala ngokuhlolwa kwegazi. Lezi zivivinyo zibheke ukusabela komzimba wakho ku- gluten , iphrotheni etholakala ngokolweni, ibhali, ne-rye ezidala isifo se-celiac.
Ukuhlolwa kwegazi akuphelele. Uma ukuhlolwa kwegazi le-celiac kungalungile, kusho ukuthi awuncane kakhulu ukuthi ube nesifo se-celiac, kodwa kusekhona ithuba elincane ukuthi unalo.
Uma ukuhlolwa kwegazi kwakho kulungile, kusho ukuthi kungenzeka ukuthi unesifo se-celiac, nakuba uzohlala (ezimweni eziningi) udinga inqubo yezokwelapha eyaziwa ngokuthi i- endoscopy ukuqinisekisa ukuxilongwa.
Phakathi naleso-endoscopy, udokotela wakho uzofaka ithubhu esiswini sakho bese efika phezulu emathunjini akho amancane, bese usika amasampula amancane emgqeni wakho wamathumbu amancane ukuze ahlole ngaphansi kwe-microscope. Uma lezi sampuli ze-tishu zibonisa i-atrophy enonya , isisindo somzimba esitholakala esibhedlela se-celiac, bese unesimo.
Yebo, kuyinkqubo ende, futhi konke kuqala ngokuhlolwa kwegazi le-celiac.
Yikuphi ukuhlolwa kwegazi okwenziwayo
Izivivinyo zegazi le-celiac zibheke ama-antibodies abonisa ukuthi amasosha omzimba wakho asabela kanjani ku-gluten ekudleni kwakho-yingakho udinga ukudla i-gluten uma uhlolwe isifo se-celiac. Uma ungadli gluten ngesikhathi sokuvivinywa, ukuhlolwa kwegazi kuyoba kubi ngisho noma unesifo se-celiac.
Kunezivivinyo ezinhlanu zegazi ongazenza uma uhlolelwa isifo se-celiac:
- I-AGA (antitigliadin antibodies) -IgA
- I-AGA-IgG
- tTG (anti-tissu transglutaminase) -IgA
- I-EMA (anti-endomysial antibodies) -IgA
- Isamba se-serum IgA
Yebo, bonke babonakala sengathi isobho se-alphabet. Kodwa konke lokhu kuhlolwa kubheka izingxenye ezithile zesistimu yakho yomzimba ukuze ubone ukuthi umzimba wakho uphendukela kumaprotheni we-gluten ekudleni okudlayo.
Kuzo zonke lezi zivivinyo, ukuhlolwa kwegazi kwe-EMA-IgA kuthathwa njengokuhlolwa kwegazi okunembile kakhulu kwesifo se-celiac, okusho ukuthi uma unomphumela omuhle ku-EMA-IgA, kungenzeka ukuthi unesifo se-celiac. Kodwa-ke, i-EMA-IgA nayo ingase ilahleke abanye abantu abanesifo se-celiac, ikakhulukazi uma sebevele baqala ukuthuthukisa isimo.
Uma unesithakazelo emininingwaneni yobuchwepheshe: I-EMA imele amasosha omzimba we-antiendomysial, okuyi-antibodies akhiqizwa umzimba ohlasela izicubu zomzimba. IgA, noma i-immunoglobulin A, uhlobo olujwayelekile lwe-antibody olukhiqizwa ngumzimba wakho. Umsebenzi wayo ukusiza umzimba ukuba ubone futhi ulwe nabahlaseli bezinye izizwe njengama-toxin ezemvelo, amabhaktheriya namagciwane.
Ezinye izivivinyo ezinzima ezikhona
Ukuhlolwa kwegazi okubizwa ngokuthi i-AGA-IgA, AGA-IgG, kanye ne-tTG-IgA futhi kungabonisa ukuthi umzimba wakho uphendukela kumaprotheni we-gluten ... futhi ungase ubone abanye abantu abanesifo se-celiac esivame ukuhlolwa okunamandla kakhulu kwe-EMA-IgA ilahlekile.
Kodwa-ke, lezi zivivinyo nazo zingaveza ezinye izingozi ezingamanga, okuyilapho ukuhlolwa kubuya khona ngomphumela omuhle, kodwa umuntu empeleni akanalo isifo se-celiac. Yingakho abanye ochwepheshe besifo se-celiac beluleka ukwenza zonke izivivinyo ndawonye-ungathola isithombe esiphelele ngokwengeziwe ngaleyo ndlela.
Kwezinye izimo, abantu abanesifo sikashukela sohlobo lwe-1, isifo se-thyroid nesifo se- autoimmune sesibindi sinesinye sezivivinyo, ukuhlola kwe-TTG-IgA, ngenxa yezimo zabo. I-TTG imelela i-tissu transglutaminase, i-enzyme ejwayelekile emathunjini.
Ukuhlolwa kwegazi okuyi-tTG-IgA okubonisa ukuthi umzimba udala ama-antibodies ezithombeni zawo, okungenzeka okwenzeka ekungeneni kwe-gluten. Noma kunjalo, akusho njalo ukuthi unesifo se-celiac, ikakhulukazi uma unezinye izimo ezibalulwe. Ngakho uma unesinye salezo zimo, udokotela wakho cishe uzobheka ngokubheka kakhulu imiphumela yezinye izifo ze-celiac zegazi.
Okokugcina, iphaneli yokuhlolwa kwegazi le-celiac ngokuvamile ihlanganisa ukuhlola ebheka ukuthi ingakanani i-antibody eyodwa, i-immunoglobulin A, umzimba wakho okwenzayo. Lokhu kubalulekile ngoba abantu abaphansi kule-antibody (eyaziwa ngokuthi i-IgA) bangase babe nemiphumela emibi ekuhlolweni kwegazi le-celiac, ngisho noma benesimo.
Futhi, lokhu kubaluleke nakakhulu ngoba abantu abanesifo se-celiac bahlupheka ngalesi simo, okuthiwa yi- IgA ukuntuleka , izikhathi ezingaba ngu-10 kuya kwezi-15 ngokuphindaphindiwe kunabantu abaningi.
Abanye odokotela basebenzisa enye yalezi zivivinyo-i- antigliadin antibodies-IgG, noma i-AGA-IgG- kubantu abanesihenqo sokuzwela kwe- gluten okungenayo i -celiac. Kodwa-ke, abacwaningi baye babonisa ukuthi akuyona into eqondile ngaleyo njongo, futhi kusukela manje, ososayensi abazange bahlakulele ukuhlolwa okunembile kokuzwela kwe-gluten.
Ukuhlolwa kwe-Genetic Celiac
Abanye odokotela bancoma futhi ukuhlolwa kwamagciwane athile okwandisa ingozi yokuba nesifo se-celiac. Uma usuvele uqalile ukudla okungekho gluten , lokhu kungase kube ukuhlolwa okuwukuphela kwakho udokotela wakho uncoma ukusebenza (izivivinyo engizichazayo ngenhla azilungile uma ungadli gluten).
Ukuhlolwa kofuzo lwe-celiac akubheki ama-antibodies ku-gluten; Kunalokho, babheka izakhi ezimbili zomzimba, i- HLA-DQ2 ne- HLA-DQ8 , ehlangene nesifo se-celiac. Izakhi zakho zofuzo azishintshi, noma ngabe udla i-gluten.
Manje, ukuvivinya kwesisu se-celiac enhle akusho ukuthi unesifo se-celiac-kumane kusho ukuthi unamakhemikhali "okulungile" ukuze uthuthukise isimo. Uma ezinye izivivinyo zakho zegazi zingalungile kepha ukuhlolwa kwegciwane lakho kulungile, wena nodokotela wakho ungase unqume ukuthi kufanele uyeke ukudla i-gluten isikhathi sokuhlola ukuze ubone ukuthi iziphi izimpawu zesifo se-celiac zicacile.
Imithombo:
Ukuhlolwa kwe-Serologic ne-Genetic. Isikhungo Sezifo ZamaCeliac e-Columbia University Medical Centre.
I-University of Maryland Centre for Research Celiac. Izifo ze-Celiac: Imibuzo Ebuzwa Ngokuphindaphindiwe weqiniso