Zwolińska-Wcisło Małgorzata, Galicka-Latała Danuta, Rudnicka-Sosin Lucyna, Rozpondek Piotr
Klinika Gastroenterologii i Hepatologii, Uniwersytet Jagielloński Collegium Medicum, Kraków.
Przegl Lek. 2009;66(7):370-2.
Coeliac disease (gluten enteropathy) is a chronic inflammatory disease of the gastrointestinal (GI) tract of autoimmune etiology in genetically predisposed individuals. It is the most frequent enteropathy with frequency of 1/100 and 1/300 in the adult population in America and Europe respectively. Typical form of celiac disease including abdominal pain, weight loss, nausea is quite rare in adults. In some coeliac patients, symptoms persist in spite of strict gluten free diet. One of the reasons of this is interference of the autoimmune diseases. Results of our studies revealed in the group of 110 patients with diagnosed gluten enteropathy, coexistence of autoimmune disease, such as diabetes mellitus type 1 in 7.2% cases, hyperthyreosis on 1.8% of cases, vitiligo in 0.9% of cases, primary biliary cirrhosis in 2% of cases and rheumatoidal arthritis in 0,9 of cases. In the group of 80 ulcerative colitis patients, coexistence of celiac disease basing on serological histopatological investigation was found in 4 patients (5%).
Coexistence of coeliac disease with other autoimmune diseases is quite frequent. Gluten enteropathy symptoms may be interpreted as originating from other autoimmune disease. It can delay the diagnosis of celiac disease and introduction of gluten free diet, which improves the quality of life and protects from dangerous GI complications.
乳糜泻(麸质性肠病)是一种在遗传易感性个体中由自身免疫病因引起的胃肠道慢性炎症性疾病。它是最常见的肠病,在美国和欧洲成年人群中的发病率分别为1/100和1/300。乳糜泻的典型形式包括腹痛、体重减轻、恶心,在成年人中相当罕见。在一些乳糜泻患者中,尽管严格遵循无麸质饮食,症状仍持续存在。其中一个原因是自身免疫性疾病的干扰。我们的研究结果显示,在110例确诊为麸质性肠病的患者组中,自身免疫性疾病并存的情况如下:1型糖尿病占7.2%,甲状腺功能亢进占1.8%,白癜风占0.9%,原发性胆汁性肝硬化占2%,类风湿性关节炎占0.9%;在80例溃疡性结肠炎患者组中,基于血清学组织病理学调查发现4例(5%)并存乳糜泻。
乳糜泻与其他自身免疫性疾病并存相当常见。麸质性肠病的症状可能被解释为源于其他自身免疫性疾病。这可能会延迟乳糜泻的诊断以及无麸质饮食的引入,而无麸质饮食可改善生活质量并预防危险的胃肠道并发症。