Hansson T, Annerén G, Sjöberg O, Klareskog L, Dannaeus A
Department of Clinical Immunology, Uppsala University Hospital, Sweden.
J Pediatr Gastroenterol Nutr. 1999 Sep;29(3):286-92. doi: 10.1097/00005176-199909000-00009.
An association between Down syndrome and celiac disease has been reported. This study was conducted to determine the association between childhood celiac disease and Down syndrome in the county of Uppsala, Sweden.
All 76 children with Down syndrome (1-18 years) were screened for the occurrence of anti-gliadin antibodies (AGA) and anti-endomysium antibodies (EMA). Twelve children with suspected celiac disease were investigated further.
Increased levels of both IgA and IgG AGA were found in 26% of the children and of EMA in and 5 of 76. Celiac disease was diagnosed in at least three of the children (3.9%; 95% confidence interval 0%-8.3%), and it could have been present in as many as eight. Three of the five EMA-positive children with suspected celiac disease had the HLA phenotype DR3, DQ2.
The results show that determination of EMA is more useful as a screening test for celiac disease and for follow-up than is AGA in children with Down syndrome. The present study also confirms that celiac disease is overrepresented among Swedish children with Down syndrome and that celiac disease should be considered in all persons with Down syndrome.
已有报道称唐氏综合征与乳糜泻之间存在关联。本研究旨在确定瑞典乌普萨拉郡儿童乳糜泻与唐氏综合征之间的关联。
对所有76名唐氏综合征患儿（1至18岁）进行抗麦醇溶蛋白抗体（AGA）和抗肌内膜抗体（EMA）检测。对12名疑似乳糜泻的患儿进行了进一步调查。
26%的患儿IgA和IgG AGA水平升高，76名患儿中有5名EMA水平升高。至少3名患儿被诊断为乳糜泻（3.9%；95%置信区间0% - 8.3%），可能多达8名。5名疑似乳糜泻的EMA阳性患儿中有3名具有HLA表型DR3、DQ2。
结果表明，对于唐氏综合征患儿，EMA检测作为乳糜泻筛查试验和随访手段比AGA更有用。本研究还证实，瑞典唐氏综合征患儿中乳糜泻的发病率较高，所有唐氏综合征患者都应考虑患有乳糜泻。
