Prevalência de baixa densidade mineral óssea em crianças e adolescentes com doença celíaca em tratamento
Palavras-chave:
Doença celíaca, Densidade mineral óssea, Glutens, Dietoterapia, Criança, TratamentoResumo
CONTEXTO E OBJETIVO: Baixa densidade mineral óssea pode ser encontrada em crianças e adolescentes com doença celíaca, incluindo aqueles em tratamento com dieta sem glúten, mas dados são contraditórios. O objetivo deste estudo foi determinar a frequência de alteração da densidade mineral óssea nos pacientes em dieta sem glúten, conforme a idade ao diagnóstico e o tempo de tratamento dietético. TIPO DE ESTUDO E LOCAL: Foi realizado estudo transversal de prevalência no Ambulatório de Gastroenterologia Pediátrica do Instituto Materno Infantil Professor Fernando Figueira (IMIP). MÉTODOS: Trinta e um pacientes maiores de cinco anos com doença celíaca que estavam em dieta sem gluten foram avaliados. A densidade mineral óssea (em g/cm2 ) foi medida na coluna lombar e no corpo inteiro utilizando densitometria óssea, categorizando-a pelo critério da Sociedade Internacional para Densitometria Clínica (baixa densidade mineral óssea para a idade cronológica ≤ -2.0 escores Z). A idade ao diagnóstico e o tempo de tratamento foram confirmados pela data de início da dieta sem glúten. RESULTADOS: Baixa densidade mineral óssea para a idade cronológica foi detectada em 3/31 pacientes na coluna lombar e 1/31 no corpo inteiro (também apresentava alteração da coluna lombar). Ao diagnóstico, três pacientes com baixa densidade mineral óssea para a idade cronológica estavam com mais de 7,6 anos. Esses pacientes estavam em dieta sem glúten por seis e sete meses e 3,4 anos. CONCLUSÃO: Pacientes pediátricos com doença celíaca em tratamento a longo prazo são de risco para baixa densidade mineral óssea. Diagnóstico precoce e longo período de dieta sem glúten são diretamente implicados na normalização da densidade óssea.
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