ngu-Shaheed Hakim, MD FRCPC
April 18, 2022
Isifo seCeliac yisimo sezokwelapha lapho umzimba uba nokusabela okungavamile ku-gluten etholakala ekudleni. Ukusabela okungavamile kuholela ku ukuvuvukala okulimaza izicubu endaweni yangaphakathi yamathumbu amancane. Umonakalo ubangelwa amangqamuzana omzimba akhethekile okuthiwa i-lymphocytes ezitholakala ngamanani anda emathunjini amancane abantu abanesifo se-celiac. Elinye igama lesifo se-celiac yi-gluten-sensitive enteropathy.
I-Gluten iyi-molecule encane etholakala ngokwemvelo ukolweni, i-rye, futhi kancane. Ngenxa yalokho, ukudla okuningi okunjengezinto ezibhakiwe, i-pasta, ama-noodle, okusanhlamvu, amasoso, nophuzo oludakayo kuqukethe i-gluten. I-Gluten ivame ukudilizwa emgudwini wamathumbu ibe izingxenye ezincane ezisuke zimuncwa ngumzimba.
A i-biopsy ngokuvamile kwenziwa ngoba isiguli sinezimpawu ezisikisela isifo se-celiac (i-gluten-sensitive enteropathy), okungase kuhlanganise ubuthakathaka nesifo sohudo. Lezi zimpawu zenzeka lapho isiguli sidla ukudla okune-gluten. Ama-Biopsies ngokuvamile athathwa engxenyeni yesibili ye-duodenum, lapho izinguquko ezihambisana nesifo se-celiac kulula ukuzibona.
Ukuxilongwa kwesifo se-celiac (i-gluten-sensitive enteropathy) kudinga kokubili ukuqinisekiswa komtholampilo kanye ne-pathological. Ukuqinisekiswa komtholampilo kuvame ukwenziwa ngokuhlolwa kwegazi kwamasosha omzimba aqondise izicubu ze-transglutaminase. Lawa ma-antibodies atholakala ezigulini eziningi ezinesifo se-celiac.
Izazi zezifo zisebenzisa igama elithi intraepithelial lymphocytosis ukuchaza ukwanda kwenani lama-lymphocyte ku-epithelium yamathumbu amancane. Ngokuhamba kwesikhathi, la mangqamuzana omzimba omzimba ayalimaza i-epithelium okubangela ukulahlekelwa kwe-villi evamile. Izazi zezifo zichaza lolu shintsho njenge-atrophy noma ukufiphala kwe-villi.
I-pathologist yakho ingaqinisekisa ukuxilongwa lapho ibona ukwanda kwama-lymphocyte e-intraepithelial i-epithelium amathumbu amancane, kanye nokufiphala okungavamile noma i-atrophy kwe villi. Lokhu kufiphaza kungaphinde kubekwe esigabeni njengokumaphakathi, okumaphakathi, noma kubi. Ngokufiphala okukhulu, akukho villi ebonwayo futhi i-epithelium ibukeka iyisicaba.
Lapho kuthathwa isampula yethishu ku-duodenum ezigabeni zokuqala zesifo, ithumbu elincane lingabonisa izinguquko ezincane kuphela kuhlanganise nenani elikhulayo lama-lymphocyte egazini. i-epithelium endaweni engaphakathi yezicubu. Ezimweni eziningi zakuqala, i-villi isajwayelekile futhi umbiko uzobhekisela kulokhu njengokuthi akukho noma ukubhuqa okungalungile.
Ukutholwa kokwanda kwe-intraepithelial lymphocyte ngaphandle kwe-villous blunting akuyona nje isifo se-celiac futhi kungase kubonakale kwezinye izimo. Isibonelo, i-Helicobacter gastroenteritis, imithi (okungukuthi. I-Olmesartan), i-sprue yasezindaweni ezishisayo, ukungabekezelelani kwamaprotheni, ukwanda kwamagciwane, kanye ne-viral gastroenteritis konke kubangela izinguquko ezibukeka ngendlela efanayo ngaphansi kwesibonakhulu.