Queiroz M S, Nery M, Cançado E L, Gianella-Neto D, Liberman B
Departamento de Endocrinologia, Hospital Brigadeiro, São Paulo, SP, Brasil.
Braz J Med Biol Res. 2004 Jan;37(1):55-60. doi: 10.1590/s0100-879x2004000100008. Epub 2003 Dec 18.
The aim of the present study was to determine the prevalence of celiac disease in children of short stature and to assess whether some of the routine laboratory examinations performed to determine the cause of short stature could suggest the presence of celiac disease. A total of 106 children of short stature and no gastrointestinal symptoms were studied. An extensive endocrine work-up had been negative for all of them and an additional investigation was performed by measuring the concentration of antiendomysial antibody. Patients who were positive for antiendomysial antibody (> or =1:10) or who exhibited IgA deficiency (less than 5 mg/dl) were referred for an endoscopic intestinal biopsy. We detected a pathological titer of antiendomysial IgA in six of these patients. Five of them showed histological abnormalities compatible with celiac disease and one had normal histology and was considered to have potential celiac disease. The prevalence of celiac disease in the population studied was 4.7% (with another 0.9% of the subjects being considered to have potential celiac disease). The children with celiac disease did not differ in any of the parameters tested when compared to those without celiac disease, though they showed an improvement in growth velocity after treatment with a gluten-free diet. We conclude that it is important to test all children with short stature for celiac disease by measuring antiendomysial IgA.
本研究的目的是确定身材矮小儿童中乳糜泻的患病率,并评估一些用于确定身材矮小原因的常规实验室检查是否能提示乳糜泻的存在。共研究了106名身材矮小且无胃肠道症状的儿童。他们所有人的全面内分泌检查结果均为阴性,并通过测量抗肌内膜抗体浓度进行了进一步检查。抗肌内膜抗体呈阳性(≥1:10)或存在IgA缺乏(低于5mg/dl)的患者被转诊进行内镜肠道活检。我们在其中6名患者中检测到抗肌内膜IgA的病理滴度。其中5名患者表现出与乳糜泻相符的组织学异常,1名患者组织学正常,但被认为患有潜在乳糜泻。在所研究的人群中,乳糜泻的患病率为4.7%(另有0.9%的受试者被认为患有潜在乳糜泻)。与无乳糜泻的儿童相比,患有乳糜泻的儿童在任何测试参数上均无差异,不过他们在采用无麸质饮食治疗后生长速度有所改善。我们得出结论,通过测量抗肌内膜IgA对所有身材矮小儿童进行乳糜泻检测很重要。