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癫痫患儿中乳糜泻的患病率。

Prevalence of celiac disease in children with epilepsy.

作者信息

Vieira Camilo, Jatobá Izabele, Matos Marília, Diniz-Santos Daniel, Silva Luciana R

机构信息

Departamento de Pediatria Neurológica, Universidade Federal da Bahia, SalvadorBA, Brasil.

Faculdade de Medicina, Universidade Federal da Bahia, SalvadorBA, Brasil.

出版信息

Arq Gastroenterol. 2013 Oct-Dec;50(4):290-6. doi: 10.1590/S0004-28032013000400010.

Abstract

CONTEXT

Neurological symptoms have been well-documented in patients with celiac disease, nevertheless, the presumption of a greater prevalence of epilepsy in celiac patients remains controversial.

OBJECTIVES

To determine the frequency of celiac disease in children and adolescents with idiopathic or cryptogenic epilepsy.

METHODS

A cross-sectional study. One hundred pediatric patients with non-symptomatic epilepsy were followed-up at two public pediatric neurology clinics in Salvador, Bahia, Brazil. Screening for celiac disease was performed by serial measurements of IgA anti-transglutaminase and IgA anti-endomysium antibodies, followed by bowel biopsy in positive cases. HLA DQ02 and DQ08 were investigated in seropositive individuals, assessing the type of seizures, the number of antiepileptic drugs used and the presence gastrointestinal symptoms.

RESULTS

Three (3.0%) patients tested anti-tTG-positive, two with normal duodenal mucosa (Marsh 0) and one with intraepithelial infiltrate (Marsh I). No villous atrophy of the duodenal mucosa (Marsh III) celiac disease was found. Two patients tested positive for HLA DQ02; none were DQ08 positive.

CONCLUSION

The present study failed to prove the association between celiac disease and epilepsy.

摘要

背景

乳糜泻患者的神经系统症状已有充分记录,然而,乳糜泻患者中癫痫患病率较高这一推测仍存在争议。

目的

确定特发性或隐源性癫痫儿童及青少年中乳糜泻的发生率。

方法

一项横断面研究。对巴西巴伊亚州萨尔瓦多市两家公立儿科神经科诊所的100例无症状癫痫患儿进行随访。通过连续检测抗组织转谷氨酰胺酶IgA和抗肌内膜IgA抗体筛查乳糜泻,阳性病例随后进行肠道活检。对血清学阳性个体检测HLA DQ02和DQ08,评估癫痫发作类型、使用的抗癫痫药物数量以及胃肠道症状的存在情况。

结果

3例(3.0%)患者抗tTG检测呈阳性,2例十二指肠黏膜正常(马什0级),1例有上皮内浸润(马什I级)。未发现十二指肠黏膜绒毛萎缩(马什III级)的乳糜泻。2例患者HLA DQ02检测呈阳性;均无DQ08阳性。

结论

本研究未能证实乳糜泻与癫痫之间的关联。

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