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2009 年至 2014 年立陶宛儿童基于人群的乳糜泻筛查。

Population-Based Screening for Coeliac Disease in Lithuanian Children from 2009 to 2014.

机构信息

Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.

出版信息

Medicina (Kaunas). 2023 Sep 8;59(9):1630. doi: 10.3390/medicina59091630.

Abstract

Coeliac disease is an autoimmune disorder provoked by a dietary group of proteins called gluten in genetically predisposed individuals. Over the past several decades, the prevalence of coeliac disease has been steadily growing and it is now recognized to be occurring worldwide. The prevalence varies greatly between ethnic, racial groups and regionally. Such variability makes local epidemiological studies important for spreading awareness and setting a threshold for suspicion of coeliac disease. We explored the potential application of a quick point-of-care test for the purpose of detecting a presence of IgA class TG2 antibodies for coeliac disease and screening in a Lithuanian pediatric population. Previously, there were no data regarding coeliac disease prevalence in Lithuania. Overall, we included 1458 children 11-13 years of age from several Lithuanian schools selected randomly in this study. Utilizing one point-of-care test using a single blood sample taken from a fingertip, we identified the existence of IgA class TG2 antibodies. Only children whose parents gave consent were enrolled in the study. Those with positive IgA class TG2-ab were directed to a tertiary hospital for additional clinical assessment and confirmation of suspected coeliac disease. A total of two (0.14%) of the 1458 enrolled children were detected with the presence of TG2 antibodies and the coeliac disease diagnosis was further confirmed with histological examination of duodenal biopsy samples. Additionally, we checked that patients had not previously reported any clinical symptoms and signs that could suggest coeliac disease or any other disease of the gastrointestinal tract. The detected prevalence of coeliac disease in the Lithuanian pediatric population is 1:729. The rapid finger prick test for the presence of IgA class TG2 antibodies is a reasonable and accurate method to screen for celiac disease in children.

摘要

乳糜泻是一种由遗传易感性个体饮食中的一组蛋白质(称为麸质)引起的自身免疫性疾病。在过去的几十年中,乳糜泻的患病率一直在稳步上升,现在已被认为在全球范围内发生。患病率在种族、种族群体和地区之间差异很大。这种可变性使得当地的流行病学研究对于提高认识和确定乳糜泻的怀疑阈值非常重要。我们探讨了使用即时护理点检测 IgA 类 TG2 抗体来检测乳糜泻并在立陶宛儿科人群中进行筛查的可能性。以前,立陶宛没有关于乳糜泻患病率的数据。总的来说,我们在这项研究中包括了来自立陶宛几所随机选择的学校的 1458 名 11-13 岁的儿童。我们使用一种即时护理点测试,用指尖采集的单个血样来检测 IgA 类 TG2 抗体的存在。只有那些父母同意的孩子才被纳入研究。那些 IgA 类 TG2-ab 呈阳性的孩子被转介到三级医院进行额外的临床评估和疑似乳糜泻的确认。在 1458 名入组的儿童中,共有 2 名(0.14%)被检测到存在 TG2 抗体,乳糜泻的诊断进一步通过十二指肠活检样本的组织学检查得到证实。此外,我们还检查了患者是否没有先前报告任何可能提示乳糜泻或任何其他胃肠道疾病的临床症状和体征。在立陶宛儿科人群中,乳糜泻的检出率为 1:729。快速指尖采血检测 IgA 类 TG2 抗体是一种合理且准确的儿童乳糜泻筛查方法。

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