İnönü University Faculty of Medicine, Departments of Pediatric Gastroenterology, Hepatology, and Nutrition, Malatya, Turkey
İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
J Clin Res Pediatr Endocrinol. 2022 Dec 1;14(4):409-414. doi: 10.4274/jcrpe.galenos.2022.2022-2-14. Epub 2022 Jun 30.
A close relationship has been suggested between Celiac disease (CD) and glandular autoimmunity. The aim of this study was to determine the predictive factors for autoimmune glandular disease (AGD) in children with CD.
The study included 228 pediatric patients, diagnosed with CD between 2010 and 2019. The cases with AGD (Group 1) and those without AGD (Group 2) and the patients with type 1 diabetes mellitus (T1DM) (Group A) and those without T1DM (Group B) were retrospectively reviewed and compared in terms of clinical and laboratory features.
AGD was detected in 8.8% (n=20) of the patients: T1DM in 13 (65%), T1DM and Hashimoto’s thyroiditis (HT) in 3 (15%), HT only in 2 (10%), T1DM and Graves disease (GD) in 1 (5%), and GD only in 1(5%). The mean age at the diagnosis of CD was significantly higher in Group 1 (10.93±4.15 years) compared to Group 2 (8.10±4.19 years) (p<0.05) and also was significantly higher in Group A compared to Group B (p<0.05). Most of the diagnoses of AGD were made before the diagnosis of CD and age was an effective factor. There was no difference between Group 1 and Group 2 and Group A and Group B in terms of gender, typical/atypical CD ratio, tissue transglutaminase IgA (TTGA) level, human leucocyte antigen (HLA)-DQ2 and/or HLA-DQ8 positivity rate, and histopathological stage.
Although patients with a diagnosis of co-existent CD and AGD were significantly older than patients with isolated CD, gender, celiac symptoms, TTGA level, HLA type, and histopathological stage had no predictive value for the coexistence of AGD in patients with CD.
已有研究表明乳糜泻（CD）与腺性自身免疫之间存在密切关系。本研究旨在确定 CD 患儿发生自身免疫性腺病（AGD）的预测因素。
本研究纳入了 2010 年至 2019 年间诊断为 CD 的 228 例儿科患者。回顾性比较了有 AGD（第 1 组）和无 AGD（第 2 组）、有 1 型糖尿病（T1DM）（第 A 组）和无 T1DM（第 B 组）的患者的临床和实验室特征。
8.8%（n=20）的患者检出 AGD：T1DM 伴发者 13 例（65%），T1DM 合并桥本甲状腺炎（HT）者 3 例（15%），HT 单纯患者 2 例（10%），T1DM 合并格雷夫斯病（GD）者 1 例（5%），GD 单纯患者 1 例（5%）。第 1 组（10.93±4.15 岁）的 CD 确诊年龄显著高于第 2 组（8.10±4.19 岁）（p<0.05），第 A 组（10.93±4.15 岁）也显著高于第 B 组（p<0.05）。大多数 AGD 诊断是在 CD 诊断之前做出的，年龄是一个有效的影响因素。第 1 组和第 2 组以及第 A 组和第 B 组之间的性别、典型/非典型 CD 比例、组织转谷氨酰胺酶 IgA（TTGA）水平、人类白细胞抗原（HLA）-DQ2 和/或 HLA-DQ8 阳性率以及组织病理学分期无差异。
尽管同时患有 CD 和 AGD 的患者明显比单纯 CD 患者年龄更大，但性别、乳糜泻症状、TTGA 水平、HLA 类型和组织病理学分期对 CD 患者同时存在 AGD 并无预测价值。
