Castillo-Ortiz José Dionisio, Durán-Barragán Sergio, Sánchez-Ortíz Adriana, Ramos-Remus Cesar
Hospital de Especialidades, UMAE Centro Médico Nacional de Occidente del Instituto Mexicano del Seguro Social, Guadalajara, México.
Reumatol Clin. 2011 Jan-Feb;7(1):27-9. doi: 10.1016/j.reuma.2010.03.006. Epub 2010 Jun 23.
Celiac disease (CD) is an enteric disease caused by dietary gluten in individuals with genetic predisposition. One of the clinical manifestations of CD is the peripheral arthritis that may simulate RA.
To determine the frequency of anti-gliadin (aGL), anti-tissue transglutaminase (aTGT) and ultra purified anti-gliadin (AGLU) antibodies in patients with RA.
Cross-sectional study. We included consecutive patients diagnosed as RA (ACR). Demographic and clinical data was registered by direct interview and serum levels of aGL, aTGT y aGLU were determined using ELISA.
Eighty-five RA patients were included; 87% were women. Mean age was 44±12 years, mean disease duration 12 ±9 years. aGL IgG antibodies were positive in 16 patients, IgA aGL antibodies in 29 patients, aGLU in 14 patients and only one patient had aTGT.
It is possible that CD may be the correct diagnosis in a patient with polyarthritis, even if the patient meets the ACR criteria for RA. In other words, CD should be considered among the differential diagnoses in a patient with poly-arthritis.
乳糜泻(CD)是一种由遗传易感性个体摄入膳食麸质引起的肠道疾病。CD的临床表现之一是可能模拟类风湿关节炎(RA)的外周关节炎。
确定RA患者中抗麦醇溶蛋白(aGL)、抗组织转谷氨酰胺酶(aTGT)和超纯抗麦醇溶蛋白(AGLU)抗体的频率。
横断面研究。我们纳入了连续诊断为RA(美国风湿病学会标准)的患者。通过直接访谈记录人口统计学和临床数据,并使用酶联免疫吸附测定法测定aGL、aTGT和AGLU的血清水平。
纳入85例RA患者;87%为女性。平均年龄为44±12岁,平均病程为12±9年。16例患者的aGL IgG抗体呈阳性,29例患者的IgA aGL抗体呈阳性,14例患者的AGLU呈阳性,仅1例患者的aTGT呈阳性。
即使患者符合RA的美国风湿病学会标准,对于多关节炎患者,乳糜泻也可能是正确的诊断。换句话说,在多关节炎患者的鉴别诊断中应考虑乳糜泻。