Kushandisa Marsh Zvikoro Kuti Uongorore Dambudziko reCeliac

Marsh zvikwata zvinokonzerwa nemukoma kunokonzerwa nechirwere chechiliac

Kana iwe uri kuongororwa nechirwere chechiliac , chiremba wako angangodaro aita endoscopy uye biopsy kuona kana intara yako duku yakakuvadzwa ne gluten , puroteni yakawanikwa mugorosi, bhari, uye rye. Chiremba wako achashandisa chiremba chechiremba, chinonzi endoscope, nekamu kamera kuti utarise zvakananga pane yako yepamusoro yekudya gumbo, uye inotora zviduku zviduku zvezviviri kubva pachigadziko chemukati mako.

Uchitevera endoscopy yako, chirwere chechirwere chichatarisa mazamu ako ezvitunha kuti uone kana kune dambudziko rine chokuita ne gluten. Icho chirwere chechirwere chinotarisa mamiriro ezvinhu aya sampuli zvichienderana nehurongwa hwehutano hunonzi Marsh Score. Nhamba yako ye Marsh ichasarudza kana iwe unorwara une chirwere chechiliac, pamwe chete nekufambira mberi kwako sei.

Chirwere cheCeliac haisi iye chete mamiriro ezvinhu anogona kukonzera zvimwe zvekuchinja uku, ndicho chikonzero chiitiko chinongoratidzira chimwe chezviongorori zvekuongororwa zvakarongerwa chirwere chechiliac-kunyange chirevo chinonzi "chiyero chegoridhe" chekunyatsoongorora. Zvigumisiro zvechirwere chechiliac chirwere chemuviri uye kugadzirisa kwekupedzisira kune kudya kwe-gluten- kunogonawo kubatsira mukuwana zvakakodzera kuongororwa.

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Nhanho 0

Uyu mufananidzo wakatorwa panguva yekupedzisira, kuratidza hutachiwana hwemukati hutendere hwakagadzirwa nehutano villi. Sezvo chirwere chemukati chichiita sechinyakare, hazvigone kuti munhu ane chirwere chechiliac.

Muchiitiko ichi, sampuro yebiopsy yaizonzi sa Marsh Stage 0, inozivikanwa se "pre-infiltrative stage." inonzi "pre-infiltrative" nokuti lymphocytes haisati yatanga kupinda, kana "kupinda mukati," mumatumbo.

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Zvikamu 1 ne2

Chikamu 1 Marsh chikamu chinoreva masero ari pamusoro penhengo yemukumbo, iyo inozivikanwa semasero epithelial, ane lymphocytes akawanda, masero machena eropa, pakati pavo kudarika.

Mune chirwere chinogara chidiki, haufaniri kuva nemapfupa makumi matatu emasero epithelial, asi paanoonekwa sendima 1, pane zvakawanda kupfuura izvozvo. Kana uine danho rekutanga, nhoroondo yako yehutano inogona kuverenga "kuwedzera intraepithelial lymphocytes."

Chirwere cheCeliac haisi iye chete mamiriro ezvinhu anogona kukonzera kuwedzera kwezvirwere-kurwisa lymphocytes. Iwe unogona kunge uine lymphocytes akawanda kana iwe uine chirwere chinoputika chirwere, Sjogren's syndrome, uye zvimwe kusagadzikana kwezvokudya. Utachiona hwebhakitiriya anonzi Helicobacter pylori (iyo inobatanidza nehutachi), uye kushandiswa kwepamusoro-kunorwa-zvinouraya zvakadai seAspirin neIbuprofen, zvakare kunogona kukonzera izvi.

Vanhu vane chirwere chisina kukwana avo vari kutevera kudya kwema gluten , nhengo dzepedyo dzemhuri dzevanhu vane chirwere chechiliac, uye vanhu vane dermatitis herpetiformis , chikafu chinotyisa zvikuru chinonzi chinonzi ganda kuratidzwa kwechirwere ichi, chinogonawo kuva nesero 1 Marsh pota.

Nechikwata chechipiri, unowona mamwe lymphocytes kupfuura zvinowanzoitwa uye zvakanyanya kukura pane zvinowanzoitika pakati pemukaka villi. Izvi zvinonzi "crypts," uye zvakakura-kupfuura-zvakajairika zvinonzi "hyperplastic," saka kana mushumo wehutano hwako uchitevera bhaopsy yako unoti iwe une "hyperplastic crypts" kana "crypt hyperplasia," zvinoreva kudonhedzwa kunoonekwa muhupenyu hwako zvakakura kudarika zvaizenge zviri mune zvekugara mumatumbo.

Chikamu chechipiri chakanaka chisingawanzoitiki-chinowanzoonekwa kuvanhu vane dermatitis herpetiformis.

_{Iyi photomicrograph inobva kumufananidzo 1b weLudvigsson et al. BMC Gastroenterology 2009 9:19. doi: 10.1186 / 1471-230X-9-19. Photomicrographs yakawanikwa kubva kuna Prof. Åke Öst, akanga ari sachigaro weSweden National Steering Group yeAtest Intestinal Pathology).}

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Nhanho 3

Vanachiremba vazhinji havazofungi nezvechirwere chechiliac kusvikira musikana wechipfuva uchisvika pachigamba chechitatu. Muchikamu chino, kuchinja kwechikwata chechipiri chiripo - zvimwe lymphocytes kupfuura zvinowanzoitika uye zvakakura-kudarika-zvakajairika - pamwe nekuderera uye kugadzikana kwepestinal villi , chii chinozivikanwa sevillous atrophy.

Chikamu chechitatu chine zvikamu zvitatu:

• Chikamu chinokonzera villous atrophy (Mutsara 3a): Mimba yako yemukati ichiripo, asi iduku
• Subtotal villous atrophy (Stage 3b): Mimba yako yemukati yakawanda zvikuru
• Total villous atrophy (Stage 3c): Chivako chako chomukati chakanyorova uye chisina matumbo villi rakasara

Vanhu vakawanda vanoonekwa kuti vane chirwere cheecliac vane danho rechitatu Marsh.

_{Iyi photomicrograph inobva kumufananidzo 1c weLudvigsson et al. BMC Gastroenterology 2009 9:19. doi: 10.1186 / 1471-230X-9-19. Photomicrographs yakawanikwa kubva kuna Prof. Åke Öst, wekutanga ari sachigaro weSweden National Steering Group yeBlack Intestinal Pathology.}

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Nhanho 4

Nhanho yechina ndiyo danho rakanyanya kufambisa uye nerufaro hazvionekwi zvose zvinowanzoitika. Muchitsauko 4, villi yako yakanyatsorongedzerwa (inrophied) kudengenyeka pakati pavo (the crypts) kune shrunken zvakare.

Chikamu chechina chinowanikwa pakati pevanhu vakwegura vane chirwere ichi. Kana nhamba yako ye Marsh iri danho rechina, unogona kuva nehuwandu hwehutachiwana hwehutachiona hwechikayi, kusanganisira lymphoma.

Kuonga:

_{Iyi photomicrograph inobva kumufananidzo 1d weLudvigsson et al. BMC Gastroenterology 2009 9:19. doi: 10.1186 / 1471-230X-9-19. Photomicrographs yakawanikwa kubva kuna Prof. Åke Öst, wekutanga ari sachigaro weSweden National Steering Group yeBlack Intestinal Pathology.}

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Shoko kubva

Gastroenterologists vanoshandisa maMarh scores kuti aenzanise kukanganisa kwemuviri wako wechimudumbu kubva kune chirwere chechiliac. Nhamba yako ye Marsh ichagadzirisa kana iwe une chirwere ichi, uye kuti yakawandisa sei mumimba yako villi.

Iyi nhungamiro yezvikwata zveMarsh inogona kukubatsira kuti ududzire mharidzo kubva pamimba yako yemukati. Zvisinei, kana iwe uine dambudziko kuinzwisisa, usatya kutya kutaura nechiremba wako nezvezvinorevei. Uye yeuka: kana uchitanga kudya kusina gluten, kunyange yakaipa mumatumbo kukanganisa kunofanira kutanga kupora.

> Sources:

> Ludvigsson JF et al. Kuvimbiswa kudzidza kwevillous atrophy uye madumbu ekuvhiringidza muSweden biopsy registers. BMC Gastroenterology . 2009; 9: 19.

> Snyder CL, Young DO, Green PHR, Taylor AK. GeneReviews: Celiac Disease. 2009.

> Hill ID et al. Nhungamiro yekuongororwa uye kurapwa kwechirwere chechiliac muvana: mazano eNorth America Society yePediatric Gastroenterology, Hepatology uye Nutrition. Zvinyorwa zveMwana Gastroenterology uye Nutrition. 2005; 40: 1-19.

> Stanford Medicine Surgical Pathology Criteria: Celiac Disease.