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十二指肠嗜酸性粒细胞作为乳糜泻症状的预测因子:乳糜泻和非乳糜泻消化不良患者与对照组的比较。

Duodenal eosinophils as predictors of symptoms in coeliac disease: a comparison of coeliac disease and non-coeliac dyspeptic patients with controls.

机构信息

School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.

Department of Gastroenterology and Hepatology, John Hunter Hospital, Newcastle, Australia.

出版信息

Scand J Gastroenterol. 2020 Jul;55(7):780-784. doi: 10.1080/00365521.2020.1775880. Epub 2020 Jun 13.


DOI:10.1080/00365521.2020.1775880
PMID:32536237
Abstract

Duodenal eosinophilia is a key feature of functional dyspepsia, particularly in those with early satiety. Duodenal eosinophilia is also recognised in coeliac disease, although its relevance to symptoms is not understood. We aimed to determine if duodenal eosinophilia is present in patients with coeliac disease presenting with dyspepsia, and whether other histological characteristics were associated with clinical features on presentation. The coeliac study population comprised 61 patients with a new presentation of coeliac disease to a single centre from 2003 to 2013. A standard symptom assessment was documented for all patients. The control population (55 adults) presenting for endoscopy without coeliac disease was drawn from the same centre with similar demographics for age and gender. Duodenal biopsies from both groups were assessed for eosinophil counts and histological features. Dyspepsia was present in 18.0% of coeliac patients and early satiety in 24.6%. The eosinophil counts were significantly higher in the stomach (12.1/mm vs. 4.0/mm,  < .001) and duodenum (60.4/mm vs. 18.0/mm,  < .001) of coeliac patients compared with controls. There was no significant difference in the mean duodenal eosinophil count in coeliac disease with and without early satiety (55.4/mm vs. 66.9/mm,  = .51). Duodenal eosinophilia was not associated with the severity of coeliac enteropathy. The degree of villous atrophy was associated with iron deficiency at presentation ( = .01), but not symptoms. Although duodenal eosinophil counts are higher in coeliac disease than controls, we were not able to demonstrate an association with presenting symptoms or markers of disease severity.

摘要

十二指肠嗜酸性粒细胞增多是功能性消化不良的一个关键特征,尤其是在早饱患者中。十二指肠嗜酸性粒细胞增多也见于乳糜泻,但其与症状的相关性尚不清楚。我们旨在确定在以消化不良为首发表现的乳糜泻患者中是否存在十二指肠嗜酸性粒细胞增多,以及其他组织学特征是否与首发时的临床特征相关。乳糜泻研究人群包括 2003 年至 2013 年期间在一家中心就诊的 61 例新诊断乳糜泻患者。对所有患者均进行了标准症状评估。对照组(55 名成人)为来自同一中心、年龄和性别相似的无乳糜泻内镜检查者。对两组的十二指肠活检标本进行嗜酸性粒细胞计数和组织学特征评估。在乳糜泻患者中,消化不良的发生率为 18.0%,早饱的发生率为 24.6%。与对照组相比,乳糜泻患者的胃(12.1/mm 比 4.0/mm,  < .001)和十二指肠(60.4/mm 比 18.0/mm,  < .001)的嗜酸性粒细胞计数明显更高。在有和没有早饱的乳糜泻患者中,平均十二指肠嗜酸性粒细胞计数无显著差异(55.4/mm 比 66.9/mm,  = .51)。十二指肠嗜酸性粒细胞增多与乳糜泻肠病的严重程度无关。绒毛萎缩的程度与首发时的缺铁有关(  = .01),但与症状无关。虽然乳糜泻患者的十二指肠嗜酸性粒细胞计数高于对照组,但我们未能证明其与首发症状或疾病严重程度标志物相关。

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Duodenal eosinophils as predictors of symptoms in coeliac disease: a comparison of coeliac disease and non-coeliac dyspeptic patients with controls.

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[7]
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