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493 例疑似乳糜泻患者行内镜活检的临床、实验室和组织病理学评估:与自身免疫性疾病的关系。

Clinical, Laboratory, and Histopathological Evaluation of 493 Patients Who Underwent Endoscopic Biopsy with a Presumptive Diagnosis of Celiac Disease: Association with Autoimmune Diseases.

机构信息

Department of Pathology, Health Sciences University Faculty of Medicine, Gaziosmanpaşa Health Training and Research Center, İstanbul, Turkey.

Department of Pediatric Gastroenterology, Health Sciences University Faculty of Medicine, Gaziosmanpaşa Health Training and Research Center, İstanbul, Turkey.

出版信息

Turk J Gastroenterol. 2023 Jul;34(7):681-690. doi: 10.5152/tjg.2023.22288.

Abstract

BACKGROUND/AIMS: Celiac disease is an immunological reaction provoked by gluten digestion in genetically vulnerable individuals in response to unknown environmental factors. It affects 0.7% of the world's population and occurs at a rate of 1% in most nations. We aimed to assess the clinical, laboratory, and histopathological characteristics of patients with a presumable diagnosis of celiac disease and to investigate the coexistence of autoimmune disorders.

MATERIALS AND METHODS

In this retrospective study, data were gathered from the medical files of a total of 493 individuals with a preliminary diagnosis of celiac disease who underwent endoscopic biopsies. Analysis was carried out for clinical, biochemical, and histological results, as well as the presence of autoimmune disease.

RESULTS

Per the results of serological tests used in the diagnosis of celiac disease in this series, gliadin IgA and IgG positivities were found in 33.7% (n = 54/160) and 39.4% (n = 69/175) of patients; endomysium IgA and IgG positivities were detected in 37% (n = 88/238) and 18% (n = 30/167) of patients, while tissue transglutaminase IgA and IgG positivities were detected in 47.3% (n = 115/243) and 16.3% (n = 15/92) of patients, respectively. The incidence of patients with a CD3 level of ≥30% was 69.1% in 152 patients whose CD3 levels were tested.

CONCLUSION

The general public and healthcare professionals need to be more aware of the prevalence and many signs of celiac disease. There is still a need to conduct the necessary research in this area. By boosting awareness, early diagnosis, and diet, it will be possible to prevent symptoms and negative consequences.

摘要

背景/目的:乳糜泻是一种免疫反应,由遗传易感性个体对未知环境因素的麸质消化引起。它影响世界人口的 0.7%,在大多数国家的发生率为 1%。我们旨在评估疑似乳糜泻患者的临床、实验室和组织病理学特征,并研究自身免疫性疾病的共存情况。

材料和方法

在这项回顾性研究中,共收集了 493 名初步诊断为乳糜泻并接受内镜活检的患者的病历资料。对临床、生化和组织学结果以及自身免疫性疾病的存在进行了分析。

结果

根据本系列中用于诊断乳糜泻的血清学检测结果,在 33.7%(n=54/160)和 39.4%(n=69/175)的患者中发现了麦胶蛋白 IgA 和 IgG 阳性,在 37%(n=88/238)和 18%(n=30/167)的患者中发现了内肌层 IgA 和 IgG 阳性,而在 47.3%(n=115/243)和 16.3%(n=15/92)的患者中发现了组织转谷氨酰胺酶 IgA 和 IgG 阳性。在检测 CD3 水平的 152 名患者中,CD3 水平≥30%的患者发生率为 69.1%。

结论

公众和医疗保健专业人员需要更加了解乳糜泻的流行情况和许多迹象。在这一领域仍需要进行必要的研究。通过提高认识、早期诊断和饮食,可以预防症状和负面后果。

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