Bardella Maria Teresa, Elli Luca, Velio Pietro, Fredella Clara, Prampolini Luigia, Cesana Bruno
Centre for Prevention and Diagnosis of Celiac Disease, Foundation IRCCS Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena and Chair of Gastroenterology, University of Milan, Milan, Italy.
Digestion. 2007;75(4):182-7. doi: 10.1159/000107979. Epub 2007 Sep 11.
BACKGROUND/AIMS: Celiac disease is caused by environmental and genetic factors, and the relatives of celiac patients are at higher risk of developing celiac disease than the general population. This prospective study evaluates the prevalence of celiac disease in the asymptomatic siblings of celiac patients.
Forty-eight siblings (22 males; mean age 13 years) of 39 celiac children (20 males; mean age 4 years), and 120 siblings (55 males; mean age 33 years) of 55 adult celiac patients (12 males; mean age 31 years) were serologically screened for celiac disease. Positive cases were considered for endoscopic duodenal biopsies.
Forty of the 168 asymptomatic siblings (23.8%) were affected by celiac disease. There were no differences between the index cases with and without affected siblings in terms of age at diagnosis, symptoms at onset, order of birth, associated disorders or other affected relatives. The male siblings of pediatric patients were affected in 40.9% of cases and female siblings in 26.9%; the corresponding figures for adults were 16.4 and 23.1%.
Silent celiac disease is 24-48 times more frequent in the siblings of celiac patients than in the general population. No predictive factors for sibling involvement were found. Adult females seem to tolerate gluten less than adult males.
背景/目的：乳糜泻由环境和遗传因素引起，乳糜泻患者的亲属患乳糜泻的风险高于普通人群。本前瞻性研究评估了乳糜泻患者无症状同胞中乳糜泻的患病率。
对39名乳糜泻儿童（20名男性；平均年龄4岁）的48名同胞（22名男性；平均年龄13岁）以及55名成年乳糜泻患者（12名男性；平均年龄31岁）的120名同胞进行了乳糜泻的血清学筛查。对阳性病例进行内镜下十二指肠活检。
168名无症状同胞中有40名（23.8%）患有乳糜泻。在诊断年龄、发病症状、出生顺序、相关疾病或其他受影响亲属方面，有和没有受影响同胞的索引病例之间没有差异。儿科患者的男性同胞中有40.9%受影响，女性同胞中有26.9%受影响；成人的相应数字分别为16.4%和23.1%。
乳糜泻患者的同胞中无症状乳糜泻的发生率比普通人群高24至48倍。未发现同胞受累的预测因素。成年女性似乎比成年男性更不耐受麸质。
