Trevisiol C, Not T, Berti I, Buratti E, Città A, Neri E, Torre G, Martelossi S, Tommasini A, Alù A, Barillari G, Facchini S, Ventura A
Department of Paediatrics, IRCCS Burlo Garofolo, Trieste, Italy.
Ital J Gastroenterol Hepatol. 1999 Oct;31(7):584-6.
In the past, the reported prevalence of coeliac disease ranged from 1:1000 to 1:4000, whereas recent studies using serological screening methods have found a significantly higher prevalence. The aim of this study was to investigate the prevalence of coeliac disease in healthy blood donors in a North-eastern region of Italy.
A total of 4000 healthy blood donors were studied from two immunotransfusion centres.
Serum IgA-antiendomysium antibodies were detected by indirect immunofluorescence using human umbilical cord vein sections, and positive sera were tested also on monkey oesophagus tissue. Intestinal biopsy was performed in all antiendomysium-positive subjects.
Ten out of 4000 sera screened were found to be antiendomysium positive on human umbilical cord vein. All positive patients had flat mucosa on intestinal biopsy. Five subjects had coeliac disease-related clinical features (2 had a history of gastrointestinal symptoms, 1 a family history of IDDM, 1 sideropenic anaemia, and 1 IgA deficiency). One of the ten serum, antiendomysium positive on human umbilical cord vein, was found to be negative when tested on monkey oesophagus.
These data confirm the high prevalence of undiagnosed silent coeliac disease in the healthy adult population. This is the first study where umbilical cord was used for screening coeliac disease in a large population. The human umbilical cord vein indirect immunofluorescence test is more specific for villous atrophy than conventional indirect immunofluorescence test on monkey oesophagus and is a reliable screening test for coeliac disease in an apparently healthy population.
过去，乳糜泻报告患病率在1:1000至1:4000之间，而近期使用血清学筛查方法的研究发现患病率显著更高。本研究旨在调查意大利东北部地区健康献血者中乳糜泻的患病率。
来自两个免疫输血中心的4000名健康献血者参与了研究。
使用人脐带静脉切片通过间接免疫荧光检测血清IgA-抗肌内膜抗体，对阳性血清也在猴食管组织上进行检测。对所有抗肌内膜阳性受试者进行肠道活检。
在4000份筛查血清中，有10份在人脐带静脉上检测为抗肌内膜阳性。所有阳性患者肠道活检时均有黏膜扁平。5名受试者有与乳糜泻相关的临床特征（2名有胃肠道症状史，1名有1型糖尿病家族史，1名有缺铁性贫血，1名有IgA缺乏）。在人脐带静脉上抗肌内膜阳性的10份血清中有1份在猴食管上检测时为阴性。
这些数据证实了健康成年人群中未诊断出的无症状乳糜泻患病率很高。这是第一项在大量人群中使用脐带筛查乳糜泻的研究。人脐带静脉间接免疫荧光试验对绒毛萎缩比传统的猴食管间接免疫荧光试验更具特异性，是对明显健康人群进行乳糜泻筛查的可靠试验。
