Szodoray Peter, Barta Zsolt, Lakos Gabriella, Szakáll Szabolcs, Zeher Margit
Division of Clinical Immunology, Third Department of Medicine, University of Debrecen Medical and Health Science Centre, P.O. Box 3, 4004, Debrecen, Hungary.
Rheumatol Int. 2004 Sep;24(5):278-82. doi: 10.1007/s00296-003-0360-x. Epub 2003 Sep 17.
Recent studies report that in patients with Sjögren's syndrome (SS), concomitant coeliac disease (CD) is more frequent than in the average healthy population, with dominance of the latent/silent form. We further investigated this to characterise the clinical and immunolaboratory features of SS patients with CD. One hundred and eleven patients with SS were involved in the study. After detailed history, blood samples were taken for antibodies to gliadin, endomysium, and tissue transglutaminase. Of them, six had positive serology for CD and underwent jejunoscopy and small bowel biopsy to confirm the diagnosis of CD. In five patients, the diagnosis was established histologically. The frequency of CD in the SS population was significantly higher than in the non-SS European population (4.5:100 vs 4.5-5.5:1,000). Laboratory findings in these patients showed significantly higher erythrocyte sedimentation rates and IgG, IgA, and IgM levels. On the basis of these findings, we recommend screening, follow-up, and regular gastrointestinal care of SS patients to identify CD cases and help them to avoid severe malnutrition and intestinal malignancies.
近期研究报告称，在干燥综合征（SS）患者中，并发乳糜泻（CD）的情况比一般健康人群更为常见，且以潜伏/无症状形式为主。我们进一步对此进行研究，以明确合并CD的SS患者的临床和免疫实验室特征。111例SS患者参与了本研究。在详细询问病史后，采集血样检测抗麦醇溶蛋白、抗肌内膜和抗组织转谷氨酰胺酶抗体。其中，6例CD血清学检测呈阳性，并接受了空肠镜检查和小肠活检以确诊CD。5例患者经组织学确诊。SS人群中CD的发生率显著高于非SS欧洲人群（4.5:100 vs 4.5 - 5.5:1000）。这些患者的实验室检查结果显示红细胞沉降率以及IgG、IgA和IgM水平显著升高。基于这些发现，我们建议对SS患者进行筛查、随访及定期的胃肠道护理，以识别CD病例，并帮助他们避免严重营养不良和肠道恶性肿瘤。
