Kotze Lorete Maria da Silva
Gastroenterology Service, Cajuru Hospital, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil.
Arq Gastroenterol. 2009 Oct-Dec;46(4):261-9. doi: 10.1590/s0004-28032009000400004.
Celiac disease is a multisystem auto-immune disorder and may start at any age in genetically predisposed individuals.
To identify associations, complications, and cause of death in Brazilian patients.
One hundred and fifty-seven patients were studied: 23 adolescents and 134 adults, 79.6% females, 20.4% males, 75.8% at the time of diagnosis and 24.2% on a gluten-free diet, follow-up between 1 and 40 years. The diagnosis of celiac disease was based on histologic findings and the presence of serologic auto-antibodies markers for celiac disease. Specific tests were done according to clinical suspicion of associations. Bone mineral density was determined by dual energy x-rays in 53 patients upon diagnosis. The data regarding associations, complications, and causes of death were obtained by interviews and from the patient's charts.
Associations: atopy (22.3%), depression (17.2%), thyroid disorder (15.9%), dermatitis herpetiformis (11.5%), diabetes mellitus types 1 and 2 (4.5%) and tumors (4.5%).
Anemia and osteopenia/osteoporosis in all groups; increased number of spontaneous abortion. Four patients (4.5%) died (one from lymphoma, one with diabetes type 1, one from acute meningitis and one due to suicide).
This experience is similar to those described in the world literature. Celiac disease presents the same characteristics independently of the geographic region. We recommend periodic evaluations, from childhood, independent of the duration of the diet. The key is to establish an interval between evaluations.
乳糜泻是一种多系统自身免疫性疾病，在有遗传易感性的个体中可在任何年龄发病。
确定巴西患者的关联疾病、并发症及死亡原因。
对157例患者进行研究，其中23例青少年和134例成年人，女性占79.6%，男性占20.4%，75.8%处于诊断时，24.2%采用无麸质饮食，随访时间为1至40年。乳糜泻的诊断基于组织学检查结果及乳糜泻血清学自身抗体标志物的存在。根据临床对关联疾病的怀疑进行特定检查。53例患者在诊断时通过双能X线测定骨密度。通过访谈和患者病历获取有关关联疾病、并发症及死亡原因的数据。
关联疾病：特应性疾病（22.3%）、抑郁症（17.2%）、甲状腺疾病（15.9%）、疱疹样皮炎（11.5%）、1型和2型糖尿病（4.5%）及肿瘤（4.5%）。
所有组均有贫血和骨质减少/骨质疏松；自然流产次数增加。4例患者（4.5%）死亡（1例死于淋巴瘤，1例死于1型糖尿病，1例死于急性脑膜炎，1例死于自杀）。
该经验与世界文献中描述的相似。乳糜泻呈现相同特征，与地理区域无关。我们建议从儿童期开始定期评估，与饮食持续时间无关。关键是确定评估间隔。
