Iltanen S, Collin P, Korpela M, Holm K, Partanen J, Polvi A, Mäki M
Institute of Medical Technology, University of Tampere, Finland.
Am J Gastroenterol. 1999 Apr;94(4):1042-6. doi: 10.1111/j.1572-0241.1999.01011.x.
Many autoimmune diseases occur concomitantly with celiac disease. We investigated prospectively the occurrence of celiac disease and small-bowel mucosal inflammation in patients with primary Sjögren's syndrome.
A total of 34 patients with primary Sjögren's syndrome and 28 controls underwent small bowel biopsy. Villous morphology, jejunal intraepithelial lymphocytes, and mucosal HLA-DR were evaluated and DQA and DQB alleles, serum antiendomysial, and antigliadin antibodies were examined.
Five (14.7%) of 34 Sjögren's syndrome patients were found to have celiac disease. The density of jejunal intraepithelial gammadelta+ T cells was increased in all celiac and in four nonceliac patients. All celiac patients, 69% of nonceliac Sjögren's syndrome patients, and 11% of control subjects showed enhanced HLA-DR expression (p < 0.001). HLA DQ2 was present in 19 (56%) patients with Sjögren's syndrome, including all five with celiac disease.
The findings show a close association between Sjögren's syndrome and celiac disease. Even among nonceliac patients with primary Sjögren's syndrome, an ongoing inflammation is often present in the small bowel mucosa.
许多自身免疫性疾病与乳糜泻同时发生。我们前瞻性地研究了原发性干燥综合征患者中乳糜泻和小肠黏膜炎症的发生情况。
共有34例原发性干燥综合征患者和28例对照者接受了小肠活检。评估了绒毛形态、空肠上皮内淋巴细胞和黏膜HLA - DR，并检测了DQA和DQB等位基因、血清抗肌内膜抗体和抗麦胶蛋白抗体。
34例干燥综合征患者中有5例（14.7%）被发现患有乳糜泻。所有乳糜泻患者和4例非乳糜泻患者的空肠上皮内γδ + T细胞密度均增加。所有乳糜泻患者、69%的非乳糜泻干燥综合征患者和11%的对照者均表现出HLA - DR表达增强（p < 0.001）。19例（56%）干燥综合征患者存在HLA DQ2，包括所有5例乳糜泻患者。
研究结果表明干燥综合征与乳糜泻之间存在密切关联。即使在原发性干燥综合征的非乳糜泻患者中，小肠黏膜也常存在持续的炎症。
