Paediatrics Operative Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), School of Medicine, University of Palermo, Palermo, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), School of Medicine, University of Palermo, Palermo, Italy.
Ital J Pediatr. 2024 Apr 1;50(1):59. doi: 10.1186/s13052-024-01625-w.
The aim of this study is to compare two groups of celiac patients: the first one, in which diagnosis was based on a "biopsy sparing" approach according to the 2012 ESPGHAN criteria, and the second one, based on the biopsy approach like the one of the 1991 Revised Criteria, in order to find relevant difference for sex, M/F ratio, age at diagnosis, clinical features at the onset, presence and prevalence of concomitant autoimmune disorders.
Our study involves 61 patients having the Celiac Disease (CD) onset from February 2013 to February 2020. The 32 patients who received diagnosis according "biopsy sparing" criteria were enrolled in group (1) The 29 patients who received diagnosis by duodenal biopsy were enrolled in group (2) Prevalence of comorbidities was analysed through chi-square test.
In group 1 the prevalence of comorbidities such as Insulin-Dependent Diabetes Mellitus (IDDM) and thyroiditis was of 53%, while in group 2 it was only of 24%. Analysing the IDDM prevalence between the two groups we found a relevant difference. At the same time, the prevalence of thyroiditis was also significantly different. In group 1, male patients, in particular, would seem to have a higher incidence of CD related autoimmune disorders.
An increased prevalence of IDDM, thyroiditis and juvenile idiopathic arthritis (JIA) in the first group would show that the "biopsy sparing" approach could expose patients to a greater length of disease activity that might be responsible for the onset of such comorbidities. Further studies should be carried out on more numerous samples of patients in order to confirm or not these data.
本研究旨在比较两组乳糜泻患者：第一组，根据 2012 年 ESPGHAN 标准采用“避免活检”方法进行诊断；第二组，根据 1991 年修订标准的活检方法进行诊断，以寻找性别、男女比例、诊断时年龄、发病时临床特征、伴发自身免疫性疾病的存在和流行率的相关差异。
我们的研究涉及 2013 年 2 月至 2020 年 2 月期间发病的 61 例乳糜泻患者。根据“避免活检”标准诊断的 32 例患者被纳入组 1；接受十二指肠活检诊断的 29 例患者被纳入组 2。通过卡方检验分析合并症的患病率。
在组 1 中，胰岛素依赖型糖尿病（IDDM）和甲状腺炎等合并症的患病率为 53%，而在组 2 中仅为 24%。分析两组之间 IDDM 的患病率发现存在显著差异。同时，甲状腺炎的患病率也存在显著差异。在组 1 中，男性患者似乎更易发生与 CD 相关的自身免疫性疾病。
组 1 中 IDDM、甲状腺炎和青少年特发性关节炎（JIA）的患病率增加表明，“避免活检”方法可能使患者暴露于更长时间的疾病活动期，这可能是这些合并症发生的原因。应在更多的患者样本上进行进一步的研究，以证实或否定这些数据。
