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里海南岸乳糜泻患者的流行病学、内镜、临床及病理特征

Epidemiological, Endoscopic, Clinical, and Pathological Features of Patients with Celiac Diseases in Southern Littoral of Caspian Sea.

作者信息

Bari Zohreh, Hadipour Mojtaba, Fakheri Hafez, Kazemi Arash, Maleki Iradj, Taghvaei Tarang, Hosseini Vahid, Valizadeh Seyed Mohammad, Masoumi Danial, Shahbazkhani Bijan, Shokri Shirvani Javad, Tirgar Fakheri Sepehr, Ebrahimi Reyhaneh

机构信息

Department of Internal Medicine, Gut and Liver Research Center, Non-communicable Disease Research Institute, Mazandaran University of Medical Sciences, Sari, Iran.

Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Middle East J Dig Dis. 2023 Oct;15(4):257-262. doi: 10.34172/mejdd.2023.355. Epub 2023 Oct 30.

DOI:10.34172/mejdd.2023.355
PMID:38523893
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10955989/
Abstract

Celiac disease is an autoimmune disorder resulting from gluten consumption in genetically predisposed individuals. The present study investigated the epidemiological, endoscopic, and clinicopathological features of patients with celiac disease in the southern littoral of the Caspian Sea. 140 patients with celiac disease were interviewed and examined regarding demographic characteristics, clinical symptoms, and serologic, endoscopic, and pathological findings. 44 (31.4%) of the patients were male and 68.6% were female. The mean age of the patients at diagnosis was 27.13±13.4 years (ranging from 2 to 60 years). The most common gastrointestinal (GI) symptoms were bloating (47.8%), abdominal pain (47.1%) and diarrhea (30.7%), respectively. Also, 17 (12.1%) patients did not complain of any GI symptoms.18 (12.8%) patients had aphthous stomatitis, 10.7% had dermatitis herpetiformis, 3.6% suffered from itching without a rash, two (1.4%) mentioned psoriasis and one (0.7%) had lichen planus. 19 (19.7%) of the female patients complained of menstrual bleeding disorders, 4% mentioned infertility, and 2% experienced primary amenorrhea. The most common comorbid condition was hypothyroidism in 16 (11.4%) patients. The most common endoscopic finding was duodenal scalloping (37.25%). In addition, 7.8% of the patients had a normal endoscopic appearance. 43 (30.7%) patients were classified as Marsh IIIC, 25.7% Marsh IIIB, 17.8% Marsh IIIA, 12.8% Marsh II and 12.8% were classified as Marsh I. Since celiac disease can present with non-GI manifestations and the majority of our patients had Marsh III classification, it seems that celiac disease must be considered as a routine screening test in GI clinics, and also, it should be kept in mind as a differential diagnosis in other specialty fields.

摘要

乳糜泻是一种自身免疫性疾病,由具有遗传易感性的个体摄入麸质引起。本研究调查了里海南岸地区乳糜泻患者的流行病学、内镜及临床病理特征。对140例乳糜泻患者进行了访谈,并检查了其人口统计学特征、临床症状以及血清学、内镜和病理检查结果。患者中男性44例(31.4%),女性占68.6%。诊断时患者的平均年龄为27.13±13.4岁(范围为2至60岁)。最常见的胃肠道(GI)症状分别为腹胀(47.8%)、腹痛(47.1%)和腹泻(30.7%)。此外,17例(12.1%)患者未出现任何胃肠道症状。18例(12.8%)患者有复发性阿弗他口炎,10.7%有疱疹样皮炎,3.6%有无皮疹的瘙痒,2例(1.4%)提及银屑病,1例(0.7%)有扁平苔藓。19例(19.7%)女性患者主诉月经出血紊乱,4%提及不孕,2%出现原发性闭经。最常见的合并症是16例(11.4%)患者患有甲状腺功能减退症。最常见的内镜检查发现是十二指肠扇贝样改变(37.25%)。此外,7.8%的患者内镜表现正常。43例(30.7%)患者被分类为马什IIIC型,25.7%为马什IIIB型,17.8%为马什IIIA型,12.8%为马什II型,12.8%被分类为马什I型。由于乳糜泻可表现为非胃肠道表现,且我们的大多数患者为马什III型分类,因此似乎在胃肠诊所必须将乳糜泻视为常规筛查试验,此外,在其他专科领域也应将其作为鉴别诊断加以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b686/10955989/e7a431b68255/mejdd-15-257-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b686/10955989/e7a431b68255/mejdd-15-257-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b686/10955989/e7a431b68255/mejdd-15-257-g001.jpg

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本文引用的文献

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Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review.乳糜泻贫血的多因素病因及无麸质饮食的影响:全面综述。
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The Skin in Celiac Disease Patients: The Other Side of the Coin.《乳糜泻患者的皮肤:另一面》。
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Celiac disease in Iran: a systematic review and meta-analysis.伊朗的乳糜泻:一项系统评价与荟萃分析
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Autoimmun Rev. 2015 Nov;14(11):1038-47. doi: 10.1016/j.autrev.2015.07.007. Epub 2015 Jul 17.
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