Enfermedad celíaca de presentación tardía en pacientes adultos
DOI:
https://doi.org/10.5281/zenodo.4110978Keywords:
enfermedad celíaca, adultos mayores, síndrome de malabsorción, glutenAbstract
Introducción: La enfermedad celíaca es una enteropatía autoinmune crónica que ocurre en individuos genéticamente predispuestos después de la ingestión de gluten de trigo y fracciones proteicas relacionadas de otros granos. Durante mucho tiempo, la enfermedad celíaca se consideró una enfermedad de la infancia y se pensaba que rara vez se presentaba en personas mayores. Ahora hay cada vez más pruebas que muestran una mayor tasa de diagnóstico entre los adultos.
Materiales y métodos: Esta revisión se centra en la epidemiología, presentaciones clínicas, complicaciones, diagnóstico y manejo de la enfermedad celíaca en la población de edad avanzada, a partir de una revisión bibliográfica sistematizada.
Resultados: Informes recientes sugieren una tendencia hacia una mayor incidencia de la enfermedad celíaca, particularmente entre las personas mayores. A pesar del creciente conocimiento sobre la enfermedad celíaca, se sabe muy poco acerca de esta afección en las personas mayores. Esta falta de conciencia, junto con la menor frecuencia de síntomas típicos en pacientes celíacos mayores en comparación con los más jóvenes, conduce a retrasos significativos en el diagnóstico de enfermedad celíaca en esta población que a su vez aumenta la morbilidad y la mortalidad en este grupo. En adultos, la enfermedad celíaca puede persistir durante muchos años antes del diagnóstico, causando síntomas sutiles o bastante preocupantes y puede presentarse por primera vez con complicaciones fatales graves.
Conclusiones: Una mayor conciencia de la incidencia y la presentación clínica de la enfermedad celíaca en los adultos es esencial para prevenir retrasos prolongados en el diagnóstico. Si bien el tratamiento para la enfermedad celíaca es relativamente sencillo, los adultos, sobre todos los de edad avanzada, presentan desafíos específicos en el manejo de su enfermedad celíaca, particularmente en vista de tener que realizar cambios radicales en la dieta y hacer frente a las complicaciones de la malabsorción de larga data. Un enfoque integral y multidisciplinario para el tratamiento de la enfermedad celíaca debería reducir la morbilidad en estos pacientes. Un enfoque de gestión adaptado a los desafíos particulares que presentan los pacientes celíacos de edad avanzada es crucial para su éxito.
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