Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Acta Paediatr. 2019 Apr;108(4):681-687. doi: 10.1111/apa.14324. Epub 2018 Apr 19.
This study investigated the prevalence of extraintestinal manifestations (EIM) in paediatric coeliac disease and their associations with other disease features.
Researchers at the University of Tampere, Finland, compared EIM in 511 children diagnosed with coeliac disease from 2003 to 2014 and 180 diagnosed with functional gastrointestinal disorders from 2007 to 2013. Disease severity and dietary responses were also compared between coeliac children diagnosed by screening (n = 146) or because of EIM (n = 116) or gastrointestinal symptoms (n = 249).
Coeliac patients had more EIM (62%) than those with functional disorders (33%). The most common EIM in coeliac children were poor growth (27%) and anaemia (18%). Children with coeliac disease often showed fatigue (8%) and symptoms affecting the skin (15%), nervous system (9%) and joints (6%). Coeliac patients with EIM as their main clinical presentation had more severe symptoms and histological damage at diagnosis than those with gastrointestinal presentation and screen-detected cases. The subgroups did not differ with regard to other clinical and laboratory parameters and dietary adherence. Concomitant EIM were also common in children diagnosed because of gastrointestinal presentation (60%) and by screening (37%).
EIM were common in coeliac disease and associated with more severe clinical and histological presentation.
本研究旨在调查儿科乳糜泻患者肠外表现（EIM）的患病率，并探讨其与其他疾病特征的关系。
芬兰坦佩雷大学的研究人员比较了 2003 年至 2014 年间确诊的 511 例乳糜泻患儿和 2007 年至 2013 年间确诊的 180 例功能性胃肠疾病患儿的 EIM。还比较了因筛查（n=146）、EIM（n=116）或胃肠道症状（n=249）而确诊的乳糜泻患儿之间的疾病严重程度和饮食反应。
乳糜泻患儿的 EIM 发生率（62%）高于功能性疾病患儿（33%）。乳糜泻患儿最常见的 EIM 是生长不良（27%）和贫血（18%）。乳糜泻患儿常表现为疲劳（8%）和影响皮肤（15%）、神经系统（9%）和关节（6%）的症状。以 EIM 为主要临床表现的乳糜泻患儿在诊断时的症状和组织学损伤比以胃肠道表现和筛查发现的患儿更为严重。这些亚组在其他临床和实验室参数以及饮食依从性方面没有差异。因胃肠道表现（60%）和筛查（37%）而确诊的患儿也常伴有合并的 EIM。
EIM 在乳糜泻中很常见，且与更严重的临床和组织学表现相关。
