Mansour Abbas Ali, Najeeb Alaa A
Department of Medicine, Basrah College of Medicine, Basrah, Iraq.
Arab J Gastroenterol. 2011 Jun;12(2):103-5. doi: 10.1016/j.ajg.2011.04.007. Epub 2011 May 31.
High prevalence rates of coeliac disease (CD) in patients with type 1 diabetes mellitus (T1DM) have been reported. The aim of this study was to evaluate the frequency of silent CD in a sample of Iraqi patients with T1DM.
This is a cross-sectional study done in Baghdad Teaching Hospital, Baghdad Medical City, Baghdad, Iraq, on 62 patients with T1DM. For all patients, immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (IgA tTG), IgG anti-tissue transglutaminase antibodies (IgG tTG), IgA endomysial antibody (IgA EMA), IgA antigliadin antibodies (IgA AGA) and IgG antigliadin antibodies (IgG AGA) tests were done, with duodenoscopy, and at least four biopsies were taken from the second part of the duodenum.
A total of 27 patients (43.5%) had normal small-intestinal histopathology (Marsh 0), one of them had a positive result for all serological markers used in the study, and another patient was positive for IgA tTG only. Ten patients (16.1%) had Marsh grade I, one of them was positive for IgA tTG, IgG tTG and IgA EMA, another patient was IgA deficient and had positive IgG tTG only and another patient with Marsh I had positive IgA tTG and IgG tTG only. Two patients (3.2%) had Marsh IIIA; three patients (4.8%) had Marsh IIIB histopathology, two of them were positive for all tests and one had positive IgA tTG and IgA EMA only. Two patients (3.2%) had Marsh IIIC histopathological features; they were positive for all serological tests, hence, the frequency of CD was 11.2%.
The frequency of silent CD in Iraqi patients with T1DM is not rare, reaching up to 11.2%. Both EMA and tTG antibodies are useful as screening tests.
有报道称1型糖尿病（T1DM）患者中乳糜泻（CD）的患病率较高。本研究的目的是评估伊拉克T1DM患者样本中隐匿性CD的发生率。
这是一项在伊拉克巴格达医学城巴格达教学医院对62例T1DM患者进行的横断面研究。对所有患者进行了免疫球蛋白A（IgA）抗组织转谷氨酰胺酶抗体（IgA tTG）、免疫球蛋白G（IgG）抗组织转谷氨酰胺酶抗体（IgG tTG）、IgA肌内膜抗体（IgA EMA）、IgA抗麦醇溶蛋白抗体（IgA AGA）和IgG抗麦醇溶蛋白抗体（IgG AGA）检测，并进行十二指肠镜检查，从十二指肠第二部至少取4块活检组织。
共有27例患者（43.5%）小肠组织病理学正常（马什0级），其中1例患者所有研究中使用的血清学标志物检测结果均为阳性，另1例患者仅IgA tTG检测结果为阳性。10例患者（16.1%）为马什I级，其中1例患者IgA tTG、IgG tTG和IgA EMA检测结果为阳性，另1例患者IgA缺乏，仅IgG tTG检测结果为阳性，另1例马什I级患者仅IgA tTG和IgG tTG检测结果为阳性。2例患者（3.2%）为马什IIIA级；3例患者（4.8%）有马什IIIB级组织病理学表现，其中2例所有检测结果均为阳性，1例仅IgA tTG和IgA EMA检测结果为阳性。2例患者（3.2%）有马什IIIC级组织病理学特征；他们所有血清学检测结果均为阳性，因此，CD的发生率为11.2%。
伊拉克T1DM患者中隐匿性CD的发生率并不罕见，高达11.2%。EMA和tTG抗体均可用作筛查检测。
