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肠抗内膜抗体是诊断小儿和成人乳糜泻的有用工具。

Intestinal Anti-Endomysium Antibodies Are a Useful Tool for Diagnosing Celiac Disease in Pediatric and Adult Patients.

机构信息

Institute for Maternal and Child Health, I.R.C.C.S. Burlo Garofolo, Via dell'Istria 65/1, 34100 Trieste, Italy.

Gastroenterology and Digestive Endoscopy Unit, Academic Hospital Cattinara, Strada di Fiume, 447, 34149 Trieste, Italy.

出版信息

Nutrients. 2024 Sep 4;16(17):2979. doi: 10.3390/nu16172979.

Abstract

Intestinal anti-endomysium antibodies are a specific marker of celiac disease. The diagnostic accuracy of this marker seems high in pediatric patients and has not yet been investigated in adults, so the aim of this prospective multicentric study was to evaluate the specificity and sensitivity of this marker in childhood and adulthood. Pediatric and adult patients undergoing intestinal endoscopy for any intestinal condition were enrolled. Serological celiac disease markers and HLA type were evaluated in all patients. Intestinal biopsies were analyzed for standard histology and for intestinal anti-endomysium antibodies with biopsy culture assay. In this study, 291 patients (145 adults and 146 children) were included. In the adult population, 34 were diagnosed with celiac disease, 105 were controls, and, in 6, celiac disease was not confirmed. In the pediatric population, 77 were diagnosed with celiac disease, 57 were controls, and, in 12, celiac disease was not confirmed. High diagnostic sensitivity and specificity of intestinal anti-endomysium antibodies were confirmed in children and additionally proven in adults. To conclude, we can affirm that intestinal anti-endomysium antibodies can be detected with high diagnostic accuracy in both children and adults. The implementation of this marker in the diagnostic work-up would help clinicians to correctly identify celiac disease.

摘要

肠抗肌内膜抗体是乳糜泻的特异性标志物。该标志物在儿科患者中的诊断准确性似乎较高,而在成人中尚未进行研究,因此本前瞻性多中心研究旨在评估该标志物在儿童和成人中的特异性和敏感性。接受任何肠道疾病内镜检查的儿科和成年患者均被纳入研究。所有患者均进行血清乳糜泻标志物和 HLA 类型评估。对肠道活检进行标准组织学和肠道抗肌内膜抗体活检培养分析。在这项研究中,共纳入 291 例患者(145 例成年患者和 146 例儿童患者)。在成年患者中,34 例被诊断为乳糜泻,105 例为对照组,6 例未确诊为乳糜泻。在儿科患者中,77 例被诊断为乳糜泻,57 例为对照组,12 例未确诊为乳糜泻。肠抗肌内膜抗体在儿童和成人中的诊断敏感性和特异性均较高。综上,我们可以确认肠抗肌内膜抗体在儿童和成人中均具有较高的诊断准确性。该标志物在诊断中的应用将有助于临床医生正确识别乳糜泻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7416/11396887/cb6245cfd615/nutrients-16-02979-g001.jpg

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