Lazzari R, Collina A, Arena G, Bochicchio A, Corvaglia L, Vallini M, Marzatico M, Forchielli L, Pasetti A, Frassineti S
Clinica Pediatrica III, Università di Bologna, Italia.
Pediatr Med Chir. 1994 Nov-Dec;16(6):549-50.
Since the beginning of the use of Antigliadin Antibodies (AGA) in the screening of coeliac disease (CD) we have observed an increasing in the total number of cases diagnosed, in particular of the cases with monosymptomatic and atypical forms. Iron deficiency anemia is one of the more frequent findings that we can find in CD, either in association with other typical coeliac signs, or as an isolated expression of the disease. The first aim of our study was to determine the incidence of iron deficiency anemia in our patients affected by CD at the moment of diagnosis. The second aim was to determine the incidence of CD in a group of 96 patients attending our Pediatric Hematology department for iron deficiency anemia of unknown etiology and refractory to iron therapy. 103 patients out of our 212 coeliacs (48.5%) showed hypochromic and microcytic anemia. In the second sample we found 6 (6.2%) patients, positive in AGA and Antiendomysium Antibodies (AEA), that showed a typical coeliac picture at the jejunal biopsy. Our study confirms the high incidence of iron deficiency anemia in patients affected by coeliac disease. However the most important conclusion of our study is that a certain percentage of patients affected by hypochromic anemia of unknown etiology may be affected by coeliac disease. It is only by performing the specific screening tests (AGA and AEA) in the patients affected by iron deficiency anemia of unknown etiology, that we can diagnose this monosymptomatic expression of CD.
自从开始使用抗麦醇溶蛋白抗体（AGA）筛查乳糜泻（CD）以来，我们观察到诊断出的病例总数不断增加，尤其是单症状和非典型形式的病例。缺铁性贫血是我们在乳糜泻中较为常见的发现之一，它既可以与其他典型的乳糜泻体征相关联，也可以作为该疾病的孤立表现。我们研究的首要目的是确定在诊断时患有乳糜泻的患者中铁缺铁性贫血的发病率。第二个目的是确定在我们儿科血液科就诊的9名因不明病因的缺铁性贫血且铁治疗无效的患者中乳糜泻的发病率。我们212名乳糜泻患者中有103名（48.5%）表现为低色素性小细胞贫血。在第二个样本中，我们发现6名（6.2%）AGA和抗肌内膜抗体（AEA）呈阳性的患者，在空肠活检时表现出典型的乳糜泻症状。我们的研究证实了乳糜泻患者中铁缺铁性贫血的高发病率。然而，我们研究最重要的结论是，一定比例病因不明的低色素性贫血患者可能患有乳糜泻。只有对病因不明的缺铁性贫血患者进行特定的筛查试验（AGA和AEA），我们才能诊断出这种乳糜泻的单症状表现。
