Hashemi Jalal, Hajiani Eskandar, Shahbazin H-Bb, Masjedizadeh Rahim, Ghasemi Navab
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran.
World J Gastroenterol. 2008 Dec 28;14(48):7376-80. doi: 10.3748/wjg.14.7376.
To determine the prevalence of celiac disease (CD) in children with idiopathic short stature (ISS) and the diagnostic value of immunoglobulin (Ig) A G antigliadin antibodies (AGA) and transglutaminase (TTG) antibodies for CD.
A total of 104 children (49 male, 55 female) with ISS without a specific etiology were studied. Extensive endocrine investigations had shown no abnormalities in any subject. Anthropometric parameters and IgA AGA and IgA TTG antibodies were evaluated in this study group. These antibodies were measured by enzyme-linked immunosorbent assay. All patients were referred for an endoscopic intestinal biopsy. The biopsy samples were classified according to revised Marsh criteria (UEGW 2001).
We detected positive IgA TTG antibodies in 36 and IgA AGA in 35 of these patients. Thirty one IgA TTG antibody positive and 28 IgA AGA positive subjects showed histological abnormalities compatible with celiac disease (33.6%). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value for IgA AGA were found to be 80%, 88.4%, 77.8% and 89.7%, respectively. Sensitivity, specificity and PPV for IgA TTG antibodies were 88.6%, 94.2% and 88.6%, respectively.
We conclude that the prevalence of celiac disease is high in patients with ISS and it is important to test all children with ISS for celiac disease by measuring serologic markers and performing an intestinal biopsy.
确定特发性身材矮小(ISS)儿童中乳糜泻(CD)的患病率,以及免疫球蛋白(Ig)A 型抗麦胶蛋白抗体(AGA)和转谷氨酰胺酶(TTG)抗体对 CD 的诊断价值。
对 104 例无特定病因的 ISS 儿童(49 例男性,55 例女性)进行研究。广泛的内分泌检查显示所有受试者均无异常。在该研究组中评估人体测量参数以及 IgA AGA 和 IgA TTG 抗体。这些抗体通过酶联免疫吸附测定法进行检测。所有患者均接受内镜肠道活检。活检样本根据修订的 Marsh 标准(欧洲胃肠病学和肝脏病学联合会,2001 年)进行分类。
在这些患者中,我们检测到 36 例 IgA TTG 抗体阳性,35 例 IgA AGA 阳性。31 例 IgA TTG 抗体阳性和 28 例 IgA AGA 阳性受试者显示出与乳糜泻相符的组织学异常(33.6%)。发现 IgA AGA 的敏感性、特异性、阳性预测值(PPV)和阴性预测值分别为 80%、88.4%、77.8%和 89.7%。IgA TTG 抗体的敏感性、特异性和 PPV 分别为 88.6%、94.2%和 88.6%。
我们得出结论,ISS 患者中乳糜泻的患病率很高,通过检测血清学标志物和进行肠道活检对所有 ISS 儿童进行乳糜泻检测很重要。