Shamaly Hussein, Mahameed Ahmad, Sharony Asher, Shamir Raanan
Pediatric Gastroenterology and Nutrition Service, Department of Pediatrics, French Hopsital, Nazareth, Israel.
Acta Obstet Gynecol Scand. 2004 Dec;83(12):1184-8. doi: 10.1111/j.0001-6349.2004.00592.x.
Celiac disease (CD) prevalence is higher in women with infertility. Our study aims were to evaluate the prevalence of undiagnosed CD in Arab infertile women and to explore the usefulness of using more than one serological marker in the diagnostic screening for CD in this population.
Women with unexplained infertility (n = 192) and age-matched healthy controls (n = 210) were prospectively enrolled. Serum was tested for human tissue transglutaminase antibodies (TTG), antiendomysial antibodies (EMA), and immunoglobulin A. Intestinal biopsy was offered to women with positive serology or immunoglobulin A (IgA) deficiency.
CD was diagnosed in five infertile women (2.65%) and in one control (0.5%) (p = 0.11). Gastrointestinal complaints were present in 60% (three of five) of women with CD and 11.8% (22 of 187) of women without CD (p = 0.017). Anemia was reported in 80% of infertile women with CD and 4.8% of infertile women without CD (p = 0.0001).
Undiagnosed CD is prevalent in Arab infertile women as well as in Arab women in general. CD in Arab infertile women is frequently associated with gastrointestinal complaints and anemia. EMA testing is sufficient in suspected cases.
不孕女性中乳糜泻（CD）的患病率较高。我们的研究目的是评估阿拉伯不孕女性中未确诊的CD患病率，并探讨在该人群中使用多种血清学标志物进行CD诊断筛查的实用性。
前瞻性纳入原因不明的不孕女性（n = 192）和年龄匹配的健康对照者（n = 210）。检测血清中的人组织转谷氨酰胺酶抗体（TTG）、抗肌内膜抗体（EMA）和免疫球蛋白A。对血清学阳性或免疫球蛋白A（IgA）缺乏的女性进行肠道活检。
5名不孕女性（2.65%）和1名对照者（0.5%）被诊断为CD（p = 0.11）。患有CD的女性中有60%（5名中的3名）存在胃肠道不适，而未患CD的女性中有11.8%（187名中的22名）存在胃肠道不适（p = 0.017）。报告显示，患有CD的不孕女性中有80%存在贫血，而未患CD的不孕女性中有4.8%存在贫血（p = 0.0001）。
未确诊的CD在阿拉伯不孕女性以及一般阿拉伯女性中都很普遍。阿拉伯不孕女性中的CD常与胃肠道不适和贫血有关。对于疑似病例，EMA检测就足够了。
