Uçardağ Derya, Güliter Sefa, Ceneli Ozcan, Yakaryilmaz Fahri, Atasoy Pinar, Cağlayan Osman
Department of Internal Medicine, Kirikkale University, School of Medicine, Kirikkale.
Turk J Gastroenterol. 2009 Dec;20(4):266-70. doi: 10.4318/tjg.2009.0024.
BACKGROUND/AIMS: Anemia, especially due to iron deficiency, is a frequent feature in celiac disease. In this study, we aimed to define the prevalence of celiac disease in Turkish patients with iron deficiency anemia of obscure origin.
One thousand four hundred and eighty-six consecutive patients with iron deficiency anemia were evaluated for etiology. Of those, 77 patients were found to have iron deficiency anemia of obscure origin. Sera from 77 patients with iron deficiency anemia of obscure origin and 119 healthy controls were tested for IgA and IgG tissue transglutaminase (tTG) antibodies by ELISA. Endoscopic mucosal biopsies were taken from the second part of the duodenum in these patients. Histopathologic examination results of patients were stratified according to Marsh classification.
IgA and IgG class anti-tTG antibodies were found positive in 6 (7.8%) and 3 (3.9%) patients with iron deficiency anemia of obscure origin, respectively. Three patients had only IgA anti-tTG and 3 had both IgA and IgG anti-tTG antibodies. In the control group, 1 subject was positive for both IgA and IgG anti-tTG antibodies (0.7%). Six patients (7.8%) and 1 control subject (0.8%) had histopathologic findings of celiac disease (p=0.02).
Patients with iron deficiency anemia of obscure origin had increased prevalence of celiac disease. Our study results suggest that serological screening may be recommended for early detection of celiac disease in patients with iron deficiency anemia of obscure origin.
背景/目的:贫血,尤其是缺铁性贫血,是乳糜泻的常见特征。在本研究中,我们旨在确定不明原因缺铁性贫血的土耳其患者中乳糜泻的患病率。
对1486例连续性缺铁性贫血患者进行病因评估。其中,77例患者被发现患有不明原因的缺铁性贫血。采用酶联免疫吸附测定法(ELISA)检测77例不明原因缺铁性贫血患者和119例健康对照者血清中的IgA和IgG组织转谷氨酰胺酶(tTG)抗体。对这些患者取十二指肠第二部的内镜黏膜活检组织。根据马什分类法对患者的组织病理学检查结果进行分层。
不明原因缺铁性贫血患者中,IgA类和IgG类抗tTG抗体阳性分别为6例(7.8%)和3例(3.9%)。3例患者仅IgA抗tTG抗体阳性,3例患者IgA和IgG抗tTG抗体均阳性。对照组中,1例受试者IgA和IgG抗tTG抗体均阳性(0.7%)。6例患者(7.8%)和1例对照受试者(0.8%)有乳糜泻的组织病理学表现(p=0.02)。
不明原因缺铁性贫血患者中乳糜泻的患病率增加。我们的研究结果表明,对于不明原因缺铁性贫血患者,建议进行血清学筛查以早期发现乳糜泻。