Research Institute of Gastroenterology and Liver Disease, Shahid Beheshti University, M.C., Tehran, Iran.
Arch Iran Med. 2011 Mar;14(2):115-8.
Celiac disease has been reported to be associated with gastric abnormalities. The aim of this study was to assess the relationship between the prevalence of celiac disease and Helicobacter pylori infection in an Iranian population of 250 patients.
Biopsies were taken from the gastric antrum and duodenum. Morphology and histology were evaluated using the updated Sydney system and modified Marsh criteria, respectively. To simplify the interpretation of gastric lesions we classified gastritis in macroscopic and microscopic stages. Serology for anti-tissue transglutaminase antibody was performed to determine the presence of celiac disease.
Among 250 patients, 232 (93%) had histological evidence of Helicobacter pylori infection. Histological abnormalities (Marsh I to IIIc) were present in 24 (10%). Of 24 patients, 20 (83%) with histological abnormalities were infected with Helicobacter pylori. Of 250 patients, 25 (10%) had a positive anti-tissue transglutaminase antibody. Of 25 anti-tissue transglutaminase antibody positive patients, 9 (3.6%) had microscopic and macroscopic enteritis (Marsh I to IIIc).
Clinical presentation of celiac disease was not distinguishable from cases infected with Helicobacter pylori. Histology, even in patients with positive serology, was non-specific and unhelpful. We found a high prevalence of Helicobacter pylori infection and chronic gastritis, but neither was associated with celiac disease, in agreement with studies in Western populations.
已有报道称，乳糜泻与胃部异常有关。本研究旨在评估在 250 名伊朗患者人群中，乳糜泻与幽门螺杆菌感染的相关性。
从胃窦和十二指肠采集活检标本。使用更新的悉尼系统评估形态学，分别使用改良 Marsh 标准评估组织学。为简化对胃部病变的解释，我们将胃炎分为宏观和微观阶段进行分类。通过检测抗组织转谷氨酰胺酶抗体来进行乳糜泻血清学检查。
在 250 名患者中，232 名（93%）有组织学证据表明存在幽门螺杆菌感染。24 名（10%）患者存在组织学异常（Marsh I 至 IIIc）。24 名存在组织学异常的患者中，20 名（83%）感染了幽门螺杆菌。在 250 名患者中，25 名（10%）抗组织转谷氨酰胺酶抗体呈阳性。在 25 名抗组织转谷氨酰胺酶抗体阳性的患者中，9 名（3.6%）存在微观和宏观肠炎（Marsh I 至 IIIc）。
乳糜泻的临床表现与感染幽门螺杆菌的病例无法区分。即使在血清学阳性的患者中，组织学也不具有特异性且无帮助。我们发现幽门螺杆菌感染和慢性胃炎的患病率较高，但均与乳糜泻无关，这与西方人群的研究结果一致。
