Bizzaro Nicola, Villalta Danilo, Tonutti Elio, Tampoia Marilina, Bassetti Danila, Tozzoli Renato
Laboratorio di Patologia Clinica, Ospedale Civile, S. Donà di Piave (VE) 30027, Italy.
Autoimmun Rev. 2003 Oct;2(6):358-63. doi: 10.1016/s1568-9972(03)00055-7.
Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten in susceptible individuals, and is one of the most frequent genetically based diseases, with a prevalence of 1:200 in the general population. The association between CD and connective tissue diseases (CTD) and autoimmune diseases of the digestive tract (DT) has been described in several case reports but in few extensive studies, with varying prevalence. A high rate of false positive results were observed when low specific tests, such as the anti-gliadin and the guinea pig tissue transglutaminase (tTG) antibody assays were used. In a study of 400 patients with CTD and 218 with autoimmune DT disease, tested for IgA and IgG anti-tTG using the more specific human recombinant antigen, 12 cases (1.9%) of anti-tTG antibody positivity were found, but only 2 (0.3%) were confirmed as affected by CD following small bowel biopsy. Most of the patients testing false positive had primary biliary cirrhosis. In this short review we describe the association between CD and CTD, inflammatory bowel disease and primary biliary cirrhosis, with special emphasis on the diagnostic accuracy of CD antibody assays.
乳糜泻（CD）是一种自身免疫性肠病，由易感个体摄入麸质引发，是最常见的基于遗传的疾病之一，在普通人群中的患病率为1:200。CD与结缔组织病（CTD）和消化道自身免疫性疾病（DT）之间的关联在一些病例报告中有描述，但在少数广泛研究中，患病率各不相同。当使用低特异性检测方法，如抗麦醇溶蛋白和豚鼠组织转谷氨酰胺酶（tTG）抗体检测时，观察到较高的假阳性结果率。在一项对400例CTD患者和218例自身免疫性DT疾病患者的研究中，使用更具特异性的人重组抗原来检测IgA和IgG抗tTG，发现12例（1.9%）抗tTG抗体呈阳性，但小肠活检后仅2例（0.3%）被确诊为患有CD。大多数检测结果为假阳性的患者患有原发性胆汁性肝硬化。在这篇简短的综述中，我们描述了CD与CTD、炎症性肠病和原发性胆汁性肝硬化之间的关联，特别强调了CD抗体检测的诊断准确性。
