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炎症性肠病患者中的血清学乳糜泻

Serologic celiac disease in patients with inflammatory bowel disease.

作者信息

Tavakkoli Hamid, Haghdani Saeid, Adilipour Haiedeh, Daghaghzadeh Hamed, Minakari Mohammad, Adibi Peyman, Ahmadi Khalil, Emami Mohammah Hasan

机构信息

Department of Gastroenterology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2012 Feb;17(2):154-8.

Abstract

BACKGROUND

There is an association of celiac disease (CD) with several gastrointestinal illnesses. We aimed to determine the prevalence of CD in patients with inflammatory bowel disease (IBD) to evaluate the value of the routine serological tests for CD in these patients.

MATERIALS AND METHODS

patients with IBD underwent screening test for CD. The screening test was based on IgA anti-tTG antibody evaluated by ELISA method and IgA EMA (endomysial antibody) measured by the indirect immunofluorescence method. Fisher exact and chi-square and t tests were used for data analysis.

RESULTS

the study was conducted on 100 patients, with a mean age of 34.74 ± 12.03 (SD) years. The mean simplified Crohn's disease activity index was 90 ± 17 (SE) and the mean colitis activity index was 3.46± 0.96 (SE). Seventeen patients (17%) had IgA anti-tTG antibody levels above the cutoff point (> 20). Thirty-two patients were positive for IgA EMA. IgA EMA was positive in nine IgA anti-tTG positive patients (three patients with Crohn's Disease and six ones with ulcerative colitis). Then, the prevalence of serologic CD was 9% that was higher than that of general population. A significant correlation was found between the results of IgA EMA and those of IgA anti-tTG (P=0.001) whereas Fisher exact test revealed significant difference between frequency distribution of positive and negative results of IgA EMA and IgA anti-tTG in patients with ulcerative colitis and Crohn's disease (P=0).

CONCLUSION

the prevalence of serologic CD in general population in Iran has been reported to be 0.6-0.96%. Then, its prevalence in our sample size was about ten times more than that in general population.

摘要

背景

乳糜泻(CD)与多种胃肠道疾病有关。我们旨在确定炎症性肠病(IBD)患者中CD的患病率,以评估这些患者中CD常规血清学检测的价值。

材料与方法

IBD患者接受了CD筛查试验。筛查试验基于通过ELISA法评估的IgA抗组织转谷氨酰胺酶(tTG)抗体和通过间接免疫荧光法测量的IgA肌内膜抗体(EMA)。采用Fisher精确检验、卡方检验和t检验进行数据分析。

结果

该研究对100例患者进行,平均年龄为34.74±12.03(标准差)岁。简化克罗恩病活动指数平均为90±17(标准误),结肠炎活动指数平均为3.46±0.96(标准误)。17例患者(17%)的IgA抗tTG抗体水平高于临界值(>20)。32例患者IgA EMA呈阳性。9例IgA抗tTG阳性患者IgA EMA呈阳性(3例克罗恩病患者和6例溃疡性结肠炎患者)。血清学CD的患病率为9%,高于普通人群。IgA EMA结果与IgA抗tTG结果之间存在显著相关性(P=0.001),而Fisher精确检验显示溃疡性结肠炎和克罗恩病患者中IgA EMA和IgA抗tTG阳性和阴性结果的频率分布存在显著差异(P=0)。

结论

据报道,伊朗普通人群中血清学CD的患病率为0.6 - 0.96%。那么,在我们的样本量中其患病率约为普通人群的十倍。

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