Israeli Eran, Hershcovici Tiberiu, Grotto Itamar, Rouach Zvi, Branski David, Goldin Eran
Department of Gastroenterology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Isr Med Assoc J. 2010 May;12(5):266-9.
In the last decade the frequency of celiac disease diagnosis has increased in adults.
To determine disease prevalence (including silent and potential disease) in this population group.
We performed serologic screening of celiac disease in a representative and homogenous sample of a young adult general population in Israel, namely, 18 year old military conscripts, in 2003. Serologic screening was performed on serum samples randomly obtained from 850 healthy recruits (male/female = 1.1). Immunoglobulin A anti-tissue transglutaminase was determined by enzyme-linked immunosorbent assay. In cases of IgA deficiency, lgG anti-endomysial antibodies were determined. A small intestinal biopsy was offered to all patients with positive serology.
The prevalence of overt CD diagnosed prior to recruitment was 0.12% (0.1% in men and 0.14% in women). The overall prevalence based on positive serology was 1.1%. Six of nine subjects with positive serology agreed to undergo endoscopy and intestinal biopsies. In all cases, biopsies were compatible with celiac disease (five biopsies were graded as Marsh 3a and one as Marsh 3b). One subject previously reporting irritable bowel-like symptoms was diagnosed with overt atypical CD. The prevalence of overt CD diagnosed by screening was 0.12%. The ratio, of overt to silent CD was 1:8. No cases of potential CD were encountered.
Our findings suggest that CD is highly prevalent in the young adult population in Israel. Serologic screening for CD is a reliable and simple method for diagnosing this disease before symptoms or complications develop.
在过去十年中，成人乳糜泻的诊断频率有所增加。
确定该人群中的疾病患病率（包括隐匿性和潜在性疾病）。
2003年，我们对以色列年轻成年普通人群的一个具有代表性且同质的样本，即18岁的应征入伍者进行了乳糜泻的血清学筛查。对从850名健康新兵（男/女 = 1.1）中随机抽取的血清样本进行血清学筛查。通过酶联免疫吸附测定法测定免疫球蛋白A抗组织转谷氨酰胺酶。对于IgA缺乏的病例，测定IgG抗肌内膜抗体。为所有血清学阳性的患者提供小肠活检。
入伍前确诊的显性乳糜泻患病率为0.12%（男性为0.1%，女性为0.14%）。基于血清学阳性的总体患病率为1.1%。9名血清学阳性的受试者中有6人同意接受内镜检查和肠道活检。在所有病例中，活检结果均符合乳糜泻（5例活检分级为马什3a级，1例为马什3b级）。一名先前报告有肠易激综合征样症状的受试者被诊断为显性非典型乳糜泻。通过筛查确诊的显性乳糜泻患病率为0.12%。显性与隐匿性乳糜泻的比例为1:8。未发现潜在性乳糜泻病例。
我们的研究结果表明，乳糜泻在以色列年轻成年人群中高度流行。乳糜泻的血清学筛查是在症状或并发症出现之前诊断该疾病的一种可靠且简单的方法。
