Parfenov A I, Gudkova R B, Krums L M, Sabel'nikova E A, Chikunova B Z, Bykova S V, Firsova L D, Sivash E S
Ter Arkh. 2003;75(9):55-60.
To study prevalence of celiac disease (CD) among patients with chronic diarrhea (ChD).
Serum levels of IgA-antibodies to gliadin, endomysium, reticulin and tissue transglutaminase were examined in 206 patients with CD. Biopsies were obtained from a distal portion of the duodenum or a proximal portion of the jejunum.
CD was diagnosed in 35 (16.9%) of 206 patients with ChD. The disease was typical in 5 (2.4%) patients and was latent in 30 (14.5%) patients. Antibodies to gliadin, endomysium, reticulin and tissues transglutaminase in diagnostically significant titers were detected in the serum of all the examinees with CD. Formation of the antitissue antibodies occurred because of destructive-dystrophic alterations of the connective tissue of the lamina propria mucosae pointing to the autoimmune nature of a pathological process in celiac disease.
To diagnose CD in ChD patients, it is necessary to supplement standard examination with duodenobiopsy, tests for antibodies to gliadin, tissue transglutaminase and to tissue structures--endomysium and reticulin.
研究慢性腹泻（ChD）患者中乳糜泻（CD）的患病率。
检测了206例CD患者血清中抗麦醇溶蛋白、抗肌内膜、抗网硬蛋白和抗组织转谷氨酰胺酶IgA抗体水平。从十二指肠远端或空肠近端获取活检组织。
206例ChD患者中，35例（16.9%）诊断为CD。其中5例（2.4%）为典型病例，30例（14.5%）为潜伏病例。所有CD受检者血清中均检测到具有诊断意义滴度的抗麦醇溶蛋白、抗肌内膜、抗网硬蛋白和抗组织转谷氨酰胺酶抗体。抗组织抗体的形成是由于黏膜固有层结缔组织的破坏 - 营养不良性改变，这表明乳糜泻病理过程的自身免疫性质。
为诊断ChD患者中的CD，有必要在标准检查的基础上补充十二指肠活检、检测抗麦醇溶蛋白、抗组织转谷氨酰胺酶以及抗组织结构（抗肌内膜和抗网硬蛋白）的抗体检测。
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