1. SERVICE OF PEDIATRIC
GASTROHEPATOLOGY
How to really implement a control quality ? Virtut Velmishi « Mother Teresa Hospital » Tirana-Albania

2. What are people thinkıng ?
Brain tumor or leukemia are « true » disease
What kind of disease is CD whose treatement is only diet

3. Money or idea ???

4. Different countries, different economies
GDP ( per capita) (nominal)
France $
Italy $
Spain $
Turkey $
Montenegro $
Tunisia $
Albania $

5. How much cost the diagnostic of CD in Albania?
Public health care Private (clinics and hospitals)
Ig A t TG - Free euros
IgA totale - Free euros
IgA anti EMA- not performed euros
HLA DQ2/DQ8-not performed euros
Intestinal biopsy- free ( children > 3 y) euros
Biopsy interpretation –free euros
243 euros

6. What can we do?
1. Collaboration with specialised centers abroad
Sending blood samples or saliva for HLA
Sending images of intestinal biopsy
Training for biopsy by capsule (for children< 3 y)

7. First collaboration with Naples
This is a biopsy of a child
who is suspected for coeliac disease.Biopsy is performed in Albania and the images are interpreted in Naples
The biopsy is within the normal limit.
The ratio villi/criptae is difficult to measure, because of orientation problem of the sample, but in the observed villi it appears normal,
The number of Intra-Epithelial Lymphocytes if around 20% : quite normal.
The mitosis in the crypts are rare (slow proliferation).

8. Collaboration is necessary for small centers
Naples
Tirana

9. Great news from Albania!
In March 2012 we have created the first Albanian Coeliac Association (ACA)

10. THANK YOU!
Thank you!