Research Unit of Celiac Disease, Paediatric Department, Mongi SLIM's Hospital and Al Manar University, Tunis, Tunisia.
Immunol Invest. 2013;42(4):356-68. doi: 10.3109/08820139.2013.770012.
This work aims to estimate celiac disease prevalence in school-children in the island of Djerba and assess rapid method feasibility for screening. We screened 2064 schoolchildren by a rapid method to detect IgA anti-tissue transglutaminase and IgA deficiency. Children with positive results were tested for IgA anti-transglutaminase and anti-endomysium by conventional tests. In positive children, intestinal biopsy was performed. IgA deficiency suspected by rapid method was confirmed by nephelometry. In these cases IgG anti-endomysium was performed. Rapid test was positive in 7 children; conventional serology was positive in all and 6 of them accepted the biopsy. Total villous atrophy was observed in 5 while intestinal mucosa was normal in one. Among children with positive serology, 3 had silent form, 1 chronic diarrhea, one growth failure and 2 had borderline growth. IgA deficiency was suspected in 13 cases and was confirmed in 11 children tested. Prevalence of celiac disease was 0.24-0.34% and that of IgA deficiency 0.5-0.6%. This screening study confirms that celiac disease is relatively common in schoolchildren in Tunisia. It confirms also that even those with symptoms typical for celiac disease escape diagnosis. Rapid test is better accepted by parents and children than test requiring a venous blood sample.
本研究旨在评估杰尔巴岛儿童的乳糜泻患病率，并评估快速检测方法用于筛查的可行性。我们使用快速方法检测 2064 名学童的 IgA 抗组织转谷氨酰胺酶和 IgA 缺乏症。对结果阳性的儿童进行常规 IgA 抗转谷氨酰胺酶和抗内肌层抗体检测。对阳性儿童进行肠活检。通过速率法怀疑 IgA 缺乏的病例通过比浊法进行确认。在这些病例中进行 IgG 抗内肌层抗体检测。7 名儿童的快速检测呈阳性；所有儿童的常规血清学检测均为阳性，其中 6 名儿童接受了活检。5 名儿童的绒毛全部萎缩，1 名儿童的肠黏膜正常。在血清学阳性的儿童中，3 名无症状，1 名慢性腹泻，1 名生长发育迟缓，2 名生长发育边缘。13 例疑似 IgA 缺乏症，11 例经检测证实。乳糜泻的患病率为 0.24-0.34%，IgA 缺乏症的患病率为 0.5-0.6%。本筛查研究证实，乳糜泻在突尼斯儿童中较为常见。它还证实，即使是那些有乳糜泻典型症状的儿童也会被漏诊。与需要静脉采血的检测相比，快速检测更受家长和儿童的欢迎。
