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不明原因慢性高转氨酶血症中乳糜泻的患病率。

Prevalence of coeliac disease in unexplained chronic hypertransaminasemia.

作者信息

Múgica F, Castiella A, Otazua P, Muñagorri A, Recasens M, Barrio J, Elosegui E

机构信息

Gastroenterology Department, Hospital de Guipúzcoa, Guipúzcoa, Spain.

出版信息

Rev Esp Enferm Dig. 2001 Nov;93(11):707-14.

Abstract

OBJECTIVE

To determine the prevalence of coeliac disease amongst the population with unexplained chronic hypertransaminasemia in our region.

PATIENTS AND METHODS

A prospective study was carried out on 147 consecutive patients with chronic hypertransaminasemia, having previously discarded alcoholic cause, hepatotoxic drugs, B, C and Delta viral infections, autoimmune hepatitis, primary biliary cirrhosis, Jemochromatosis, alfal-antitrypsin deficiency, Wilson's disease, congestive liver and illicit drug use. Serum Ig A to gliadin and endomysium antibodies were determined. Intestinal biopsy was carried out in cases those positive for one or both antibodies.

RESULTS

One patient was positive for both IgA to gliadin and to endonisyum antibodies, whereas another three patients were positive to IgA to gliadin only. A duodenal biopsy proved normal in two, a total villous atrophy in one and subtotal atrophy in other.

CONCLUSIONS

  1. The prevalence of coeliac disease amongst the population with unexplained chronic hypertransaminasemia in our region is 1.4%. 2. In our region, screening for coeliac disease in unexplained chronic hypransaminasemia should take a secondary place.
摘要

目的

确定在我们地区原因不明的慢性高转氨酶血症人群中乳糜泻的患病率。

患者与方法

对147例连续的慢性高转氨酶血症患者进行了一项前瞻性研究,之前已排除酒精性病因、肝毒性药物、B、C和丁型病毒感染、自身免疫性肝炎、原发性胆汁性肝硬化、血色病、α1-抗胰蛋白酶缺乏症、威尔逊病、充血性肝病和非法药物使用情况。测定了血清抗麦醇溶蛋白IgA和抗肌内膜抗体。对一种或两种抗体呈阳性的病例进行肠道活检。

结果

1例患者抗麦醇溶蛋白IgA和抗肌内膜抗体均呈阳性,另外3例患者仅抗麦醇溶蛋白IgA呈阳性。十二指肠活检显示,2例正常,1例完全绒毛萎缩,另1例部分萎缩。

结论

  1. 在我们地区原因不明的慢性高转氨酶血症人群中,乳糜泻的患病率为1.4%。2. 在我们地区,对原因不明的慢性高转氨酶血症进行乳糜泻筛查应居次要地位。

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