幼年特发性关节炎患者中组织转谷氨酰胺酶抗体和 IgA 缺乏症的患病率并未增加：一项病例对照研究。
Prevalence of tissue transglutaminase antibodies and IgA deficiency are not increased in juvenile idiopathic arthritis: a case-control study.
机构信息
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Children's Healthcare of Atlanta, Atlanta, GA, USA.
出版信息
Pediatr Rheumatol Online J. 2023 Oct 5;21(1):110. doi: 10.1186/s12969-023-00890-z.
BACKGROUND
The prevalence of Celiac Disease (CD) in Juvenile Idiopathic Arthritis (JIA) has been reported to be 0.1-7% in various small studies. As a result of the limited number of research and their inconclusive results there are no clear recommendations for routine CD screening in asymptomatic patients with JIA. Our aim is to estimate the prevalence of IgA deficiency and tissue transglutaminase (tTG) IgA in a cohort of JIA followed in two large academic medical centers.
METHODS
Serum was collected and stored from all subjects and analyzed in a reference laboratory for total IgA (Quantitative Nephelometry) and tTG IgA antibody levels (Semi-Quantitative Enzyme-Linked Immunosorbent Assay). Fisher's exact tests were performed for statistical significance. Risk estimates (odds ratios) with 95% confidence intervals were calculated.
RESULTS
808 JIA cases and 140 controls were analyzed. Majority were non-Hispanic whites (72% vs. 68% p = 0.309). A total of 1.2% of cases were IgA deficient compared to none of the controls (p = 0.373). After excluding IgA deficient subjects, 2% of cases had tTG IgA ≥ 4u/mL compared to 3.6% of controls (p = 0.216) (OR = 0.5; 95% C.I = 0.1-1.4); and 0.8% of cases had tTG IgA > 10u/mL compared to 1.4% of controls (p = 0.627) (OR = 0.5; 95%C.I = 0.1-2.9).
CONCLUSIONS
Using the largest JIA cohort to date to investigate prevalence of celiac antibodies, the prevalence of positive tTG IgA was 0.8% and of IgA deficiency was 1.2%. The results did not demonstrate a higher prevalence of abnormal tTG IgA in JIA. The study did not support the routine screening of asymptomatic JIA patients for CD.
背景
在各种小型研究中，乳糜泻（CD）在幼年特发性关节炎（JIA）中的患病率为 0.1-7%。由于研究数量有限且结果不确定，因此对于无症状 JIA 患者，尚无常规 CD 筛查的明确建议。我们的目的是评估在两个大型学术医疗中心就诊的 JIA 患者队列中 IgA 缺乏和组织转谷氨酰胺酶（tTG）IgA 的患病率。
方法
从所有受试者中采集并储存血清，并在参考实验室中使用定量比浊法（定量比浊法）和半定量酶联免疫吸附试验（Semi-Quantitative Enzyme-Linked Immunosorbent Assay）分析总 IgA（定量比浊法）和 tTG IgA 抗体水平。进行 Fisher 确切检验以评估统计学意义。计算风险估计值（优势比）及其 95%置信区间。
结果
共分析了 808 例 JIA 病例和 140 例对照。大多数是非西班牙裔白人（72%对 68%，p=0.309）。与对照组相比，病例组的 IgA 缺乏总发生率为 1.2%（无 vs. 无，p=0.373）。排除 IgA 缺乏患者后，2%的病例 tTG IgA≥4u/mL，而对照组为 3.6%（p=0.216）（OR=0.5；95%CI=0.1-1.4）；0.8%的病例 tTG IgA>10u/mL，而对照组为 1.4%（p=0.627）（OR=0.5；95%CI=0.1-2.9）。
结论
本研究使用迄今为止最大的 JIA 队列来研究抗 CD 抗体的患病率，发现 tTG IgA 阳性的患病率为 0.8%，IgA 缺乏的患病率为 1.2%。结果并未显示 JIA 患者 tTG IgA 异常的患病率更高。本研究不支持对无症状 JIA 患者常规筛查 CD。
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