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慢性腹泻患者乳糜泻发病率的测定

Determination of the Frequency of Celiac Disease in Patients Presenting With Chronic Diarrhea.

作者信息

Ahmad Amtiaz, Hyder Ali, Abou Bakr Attique, Hussain Shujaat, Taha Yaseen Khan Raja, Ali Khalid Muhammad, Hassan Luck Nasir

机构信息

Department of Gastroenterology, Allama Iqbal Medical College, Jinnah Hospital, Lahore, PAK.

Department of Gastroenterology, Chandka Medical college, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, PAK.

出版信息

Cureus. 2024 Jul 2;16(7):e63638. doi: 10.7759/cureus.63638. eCollection 2024 Jul.

Abstract

INTRODUCTION

Celiac disease (CD) is a chronic inflammatory disorder affecting mainly the digestive system and accounts for more than 50% of adult cases presenting to the gastrointestinal clinic with chronic diarrhea. Therefore, in our study, we aimed to determine the prevalence of CD in patients presenting with chronic diarrhea at the gastroenterology outpatient department of Jinnah Hospital, Lahore.

METHODS

This cross-sectional study was conducted from December 9, 2021, to June 8, 2022, and included 140 patients aged 18 to 50 years with chronic diarrhea. Exclusion criteria were lack of informed consent and history of abdominal trauma or surgery. Data collected included age, gender, family history of CD, and clinical symptoms. Diagnostic measures involved serum tissue transglutaminase antibody IgA and IgG levels, endoscopy, and duodenal biopsy. Statistical analysis was performed using SPSS version 23 (IBM Corp, Armonk, NY), with a p-value of ≤0.05 considered significant.

RESULTS

Among the 140 patients, 80 (57.14%) were males, with a mean age of 21 ± 4.35 years. Common symptoms included weight loss (73.5%), abdominal pain (20.7%), and stunted growth (5.7%). A family history of CD was reported in 14.29% of patients. Endoscopy findings included fissuring of the duodenal mucosa (77.9%), decreased height of duodenal folds (15.7%), and nodularity (6.4%). Histopathological examination revealed Marsh III b (65%), Marsh III c (21.4%), and Marsh III a (9.3%). CD was diagnosed in 23.57% of patients. Significant associations were found between CD and female gender, family history of CD, weight loss, stunted growth, and Marsh III c histopathology.

CONCLUSION

CD was diagnosed in 23.57% of patients with chronic diarrhea. It was more prevalent in females and those with a family history of CD. These findings emphasize the need for considering CD in the differential diagnosis of chronic diarrhea to ensure early detection and management.

摘要

引言

乳糜泻(CD)是一种主要影响消化系统的慢性炎症性疾病,在因慢性腹泻前往胃肠病诊所就诊的成年病例中占比超过50%。因此,在我们的研究中,我们旨在确定拉合尔真纳医院胃肠病门诊中慢性腹泻患者的乳糜泻患病率。

方法

本横断面研究于2021年12月9日至2022年6月8日进行,纳入了140名年龄在18至50岁之间的慢性腹泻患者。排除标准为缺乏知情同意以及有腹部创伤或手术史。收集的数据包括年龄、性别、乳糜泻家族史和临床症状。诊断措施包括血清组织转谷氨酰胺酶抗体IgA和IgG水平、内镜检查和十二指肠活检。使用SPSS 23版(IBM公司,纽约州阿蒙克)进行统计分析,p值≤0.05被视为具有统计学意义。

结果

在140名患者中,80名(57.14%)为男性,平均年龄为21±4.35岁。常见症状包括体重减轻(73.5%)、腹痛(20.7%)和生长发育迟缓(5.7%)。14.29%的患者有乳糜泻家族史。内镜检查结果包括十二指肠黏膜裂沟(77.9%)、十二指肠皱襞高度降低(15.7%)和结节状(6.4%)。组织病理学检查显示马什III b型(65%)、马什III c型(21.4%)和马什III a型(9.3%)。23.57%的患者被诊断为乳糜泻。发现乳糜泻与女性性别、乳糜泻家族史、体重减轻、生长发育迟缓和马什III c型组织病理学之间存在显著关联。

结论

23.57%的慢性腹泻患者被诊断为乳糜泻。该病在女性和有乳糜泻家族史的患者中更为普遍。这些发现强调了在慢性腹泻的鉴别诊断中考虑乳糜泻以确保早期检测和管理的必要性。

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