Shamir R, Levine A, Yalon-Hacohen M, Shapiro R, Zahavi I, Rosenbach Y, Lerner A, Dinari G
Institute of Paediatric Gastroenterology and Nutrition, Schneider Children's Medical Centre of Israel, Petah Tikva, Israel.
Eur J Pediatr. 2000 Nov;159(11):832-4. doi: 10.1007/pl00008348.
It has recently been suggested that in adults with coeliac disease, faecal blood loss may play a role in the development of iron deficiency. A group of 45 children diagnosed with coeliac disease during 1996 and 1997 were therefore prospectively evaluated for the presence of gluten in their diet, iron deficiency anaemia, and faecal occult blood. Sixty children admitted for elective surgery or asthma served as controls. Faecal occult blood was found in four iron deficient children on normal diet, of whom three were newly diagnosed. Occult blood loss disappeared in three of the four children when gluten was removed from their diet. Faecal occult blood was found in 26.7% of children on gluten-containing diet, but not in children on gluten-free diet (P = 0.01), or in control children (P = 0.001).
Our data suggest that the incidence of occult blood loss in coeliac disease occurs mainly in newly diagnosed cases and responds to a gluten-free diet. Occult blood testing may not be warranted in the absence of iron deficiency anaemia nor in children with iron deficiency anaemia who are on a gluten-free diet.
最近有人提出，在患有乳糜泻的成年人中，粪便失血可能在缺铁性贫血的发生中起作用。因此，对1996年至1997年期间诊断为乳糜泻的45名儿童进行了前瞻性评估，以检测他们饮食中麸质的存在情况、缺铁性贫血以及粪便潜血。60名因择期手术或哮喘入院的儿童作为对照。在4名饮食正常的缺铁儿童中发现了粪便潜血，其中3名是新诊断出的。当从这4名儿童的饮食中去除麸质后，其中3名儿童的潜血消失。在食用含麸质饮食的儿童中，26.7%的儿童发现有粪便潜血，但在食用无麸质饮食的儿童中未发现（P = 0.01），在对照儿童中也未发现（P = 0.001）。
我们的数据表明，乳糜泻中潜血失血的发生率主要发生在新诊断的病例中，并且对无麸质饮食有反应。在没有缺铁性贫血的情况下，或者在食用无麸质饮食的缺铁性贫血儿童中，可能不需要进行潜血检测。
