Sahin Yasin, Sahin Sezgin, Barut Kenan, Cokugras Fugen Cullu, Erkan Tulay, Adrovic Amra, Kutlu Tufan, Kasapcopur Ozgur
Department of Paediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey.
Paediatric Rheumatology, Cerrahpasa Medical School, Istanbul University, Turkey.
Arab J Gastroenterol. 2019 Jun;20(2):95-98. doi: 10.1016/j.ajg.2019.05.005. Epub 2019 Jun 7.
Juvenile idiopathic arthritis (JIA) is characterized by autoimmune aetiology. A gene locus 4q27 related to rheumatoid arthritis, psoriatic arthritis, and coeliac disease is associated with susceptibility to JIA. There are reports indicating several patients with JIA had been diagnosed with CD. We aimed to assess the frequency of coeliac disease (CD) in patients with juvenile idiopathic arthritis (JIA).
This prospective study was carried out from October 2015 to August 2016 and included 96 patients with JIA. All patients were evaluated in terms of clinical and laboratory findings of CD. Levels of total IgA and tissue transglutaminase antibody (tTG) IgA were measured in all patients. Those with increased level of tTG IgA were further tested for anti-endomysium IgA antibodies (EMA). Gastroduodenoscopy were planned for a definite diagnosis of CD in patients with positive EMA.
Of the 96 patients in our study, 34 (35.4%) had oligoarticular form of JIA, 29 (30.2%) had polyarticular form, 12 (12.5%) had ERA form, 11 (11.5%) had systemic form, and 10 (10.4%) had psoriatic form. Sixteen of our patients (16.6%) were not using any drugs during the study. Neither EMA IgA antibodies were analysed nor gastro-duodenoscopy was performed because no patients were positive for tTG IgA. There was no difference in terms of tTG levels between the patients using NSAIDs or other drugs.
We did not find CD in children with JIA. Long term studies with more JIA patients are needed to provide more precise interpretation.
幼年特发性关节炎(JIA)以自身免疫病因学为特征。一个与类风湿关节炎、银屑病关节炎和乳糜泻相关的基因位点4q27与JIA易感性相关。有报告指出,数例JIA患者被诊断为乳糜泻(CD)。我们旨在评估幼年特发性关节炎(JIA)患者中乳糜泻(CD)的发生率。
本前瞻性研究于2015年10月至2016年8月进行,纳入96例JIA患者。所有患者均根据CD的临床和实验室检查结果进行评估。检测所有患者的总IgA水平和组织转谷氨酰胺酶抗体(tTG)IgA水平。tTG IgA水平升高的患者进一步检测抗肌内膜IgA抗体(EMA)。计划对EMA阳性的患者进行胃十二指肠镜检查以明确诊断CD。
在我们研究的96例患者中,34例(35.4%)为少关节型JIA,29例(30.2%)为多关节型,12例(12.5%)为ERA型,11例(11.5%)为全身型,10例(10.4%)为银屑病型。我们的16例患者(16.6%)在研究期间未使用任何药物。由于没有患者tTG IgA呈阳性,因此既未分析EMA IgA抗体,也未进行胃十二指肠镜检查。使用非甾体抗炎药或其他药物的患者之间tTG水平无差异。
我们在JIA患儿中未发现CD。需要对更多JIA患者进行长期研究以提供更精确的解释。