Medical Department, Desio Hospital, Milan, Italy.
Dig Liver Dis. 2010 Mar;42(3):175-8. doi: 10.1016/j.dld.2009.08.005. Epub 2009 Sep 27.
An association has been described in case reports between celiac disease and inflammatory bowel diseases. The aim of the present study is to assess the prevalence of celiac disease in a large series of Italian patients with inflammatory bowel disease.
The Italian Group for Inflammatory Bowel Disease conducted a multicentre study between January 2002 and December 2004, in which 22 gastroenterology centres in Italy enrolled 1711 consecutive outpatients with inflammatory bowel disease. 860 (50.2%) had Crohn's disease (415 females, mean age 40, range 18-75), 791 (46.2%) had ulcerative colitis (371 females, mean age 40, range 18-80), and 60 (3.5%) had indeterminate colitis (27 females, mean age 40, range 18-78). All patients underwent serological testing for anti-endomysial antibodies and anti-tissue transglutaminase antibodies; if positive upper GI endoscopy with duodenal biopsy was performed.
Nine of the 1711 patients (0.5%) had serological and histological findings compatible with the diagnosis of celiac disease; six of them had ulcerative colitis and three had Crohn's disease.
Overall we found a lower risk of celiac disease in our cohort of inflammatory bowel disease patients than in the general population; prevalence of celiac disease was higher in patients with ulcerative colitis than in those with Crohn's disease.
在病例报告中描述了乳糜泻与炎症性肠病之间存在关联。本研究旨在评估大量意大利炎症性肠病患者中乳糜泻的患病率。
意大利炎症性肠病组于 2002 年 1 月至 2004 年 12 月进行了一项多中心研究,意大利的 22 个胃肠病中心纳入了 1711 例连续的炎症性肠病门诊患者。860 例(50.2%)患有克罗恩病(415 名女性,平均年龄 40 岁,范围 18-75 岁),791 例(46.2%)患有溃疡性结肠炎(371 名女性,平均年龄 40 岁,范围 18-80 岁),60 例(3.5%)患有不确定结肠炎(27 名女性,平均年龄 40 岁,范围 18-78 岁)。所有患者均接受了抗内肌膜抗体和抗组织转谷氨酰胺酶抗体的血清学检测;如果阳性,则进行上胃肠道内镜检查和十二指肠活检。
1711 例患者中有 9 例(0.5%)存在血清学和组织学检查结果符合乳糜泻诊断;其中 6 例患有溃疡性结肠炎,3 例患有克罗恩病。
总体而言,我们在炎症性肠病患者队列中发现乳糜泻的风险低于一般人群;溃疡性结肠炎患者中乳糜泻的患病率高于克罗恩病患者。