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Dtsch Med Wochenschr 2015; 140(22): 1683-1687
DOI: 10.1055/s-0041-106311
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© Georg Thieme Verlag KG Stuttgart · New York

Nicht-Zöliakie-Nicht-Weizenallergie-Weizensensitivität

Non-celiac disease non-wheat allergy wheat sensitivity
Yurdagül Zopf
1   Medizinische Klinik 1, Friedrich-Alexander-Universität Erlangen-Nürnberg
,
Walburga Dieterich
1   Medizinische Klinik 1, Friedrich-Alexander-Universität Erlangen-Nürnberg
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Publication History

Publication Date:
04 November 2015 (online)

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Zusammenfassung

Die Nicht-Zöliakie-Nicht-Weizenallergie-Weizensensitivität stellt eine Glutenunverträglichkeit dar und wird nach Abklärung einer Zöliakie und Weizenallergie als Ausschlussdiagnose gestellt. Aufgrund fehlender diagnostischer Biomarker existieren keine genauen Zahlen zur Häufigkeit und Prävalenzen von 0,5–6 % werden beschrieben. Die Patienten klagen nach dem Verzehr von Weizenprodukten über sehr rasch auftretende intestinale Beschwerden, wie Blähungen, Bauchschmerzen, Durchfälle oder Übelkeit, die sich nach Glutenelimination schnell verbessern. Extraintestinal werden vor allem Müdigkeit, Muskelkrämpfe, Gelenkschmerzen, Kopfschmerzen und Depressionen beschrieben. Serologische Marker sind nicht bekannt und die Patienten weisen keine Mukosaschädigung auf. Die Ursache der Nicht-Zöliakie-Nicht-Weizenallergie-Weizensensitivität ist völlig unklar und neben dem Klebereiweiß Gluten werden weitere Weizenproteine, Amylase-Trypsin-Inhibitoren oder kurzkettige Kohlenhydrate sowie das intestinale Mikrobiom als auslösende Faktoren diskutiert.

Abstract

Non-celiac non-wheat allergy wheat sensitivity is regarded as discrete glutensensitivity diagnosed after the exclusion of celiac disease and wheat allergy. Due to the absence of reliable biomarkers no exact prevalence rates are known and estimations range between 0,5–6 %. Soon after ingestion of wheat, patients complain of intestinal symptoms mainly bloating, abdominal pain, diarrhea or nausea which improve fast under glutenfree diet. Often extraintestinal manifestation as tiredness, muscle or joint pain, headache and depression are reported. Actually, there are no serological markers and no intestinal mucosal damage was found in patients. The underlying mechanism of the disease is completely unknown and beside of gluten other wheat proteins as well as amylase-trypsin-inhibitor or short chain sugars are discussed as triggers. In addition, the involvement of the intestinal microbiome in pathology of glutensensitivity must be considered.

Schlüsselwörter

Weizensensitivität - Glutensensitivität - Zöliakie - Gluten - FODMAP

Keywords

wheat sensitivity - gluten sensitivity - celiac disease - gluten - FODMAP
 

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