Sabel'nikova E A, Parfenov A I, Krums L M, Gudkova R B
Ter Arkh. 2006;78(2):45-8.
To examine incidence of celiac disease in patients with iron deficiency anemia (IDA) of unclear origin.
A total of 331 IDA patients were examined for celiac disease (CD). The diagnosis was made on the basis of histological findings upon examination of the biopsy of small intestinal mucosa, detection of antibodies to alpha-gliadine (AGA) and tissue transglutaminase (TTG).
The cause of anemia was revealed in 270 (81.5%) of 331 patients. The rest 61 patients (18.4%) had anemia of unknown cause. A rise of AGA was detected in 33 (54.0%) of 61 patients, TTG--in 29 (47.5%) patients. CD was diagnosed in 29 (47.5%) patients. Four of 61 patients (6.5%) had no symptoms of malabsorption.
All the patients with IDA of unclear genesis must undergo serological tests for CD. In high titers of antibodies to AGA and TTG, retrobulbar duodenal biopsy is indicated with histological study of small intestinal mucosa.
研究不明原因缺铁性贫血(IDA)患者中乳糜泻的发病率。
共对331例IDA患者进行了乳糜泻(CD)检查。诊断基于小肠黏膜活检的组织学检查结果、α-麦醇溶蛋白抗体(AGA)和组织转谷氨酰胺酶(TTG)抗体的检测。
331例患者中270例(81.5%)贫血病因明确。其余61例患者(18.4%)贫血原因不明。61例患者中33例(54.0%)检测到AGA升高,29例(47.5%)患者检测到TTG升高。29例患者(47.5%)被诊断为CD。61例患者中有4例(6.5%)无吸收不良症状。
所有病因不明的IDA患者均须接受CD的血清学检测。对于AGA和TTG抗体高滴度的患者,建议进行球后十二指肠活检并对小肠黏膜进行组织学研究。