Corazza G R, Valentini R A, Andreani M L, D'Anchino M, Leva M T, Ginaldi L, De Feudis L, Quaglino D, Gasbarrini G
Dept. of Medical Pathology I, University of Bologna, Italy.
Scand J Gastroenterol. 1995 Feb;30(2):153-6. doi: 10.3109/00365529509093254.
Although it is known that anaemia may be the only presenting symptom in coeliac disease, prevalence figures of unsuspected coeliac disease in anaemic patients are not available. The aim of this study was to assess the clinical usefulness of antigliadin and antiendomysial antibody tests in the diagnostic algorithm of anaemic patients.
Two hundred consecutive anaemic patients were tested for antigliadin antibodies, and those positive were also tested for antiendomysial antibodies. All patients positive for antigliadin and antiendomysial antibodies underwent intestinal biopsy.
Sixteen patients were antigliadin antibody-positive, and 10 were also antiendomysial antibody-positive. In all 10 a jejunal biopsy was consistent with coeliac disease (prevalence, 5%). This prevalence rose to 8.5% when patients with macrocytic anaemia or with microcytic anaemia due to previous bleeding or responsive to oral iron therapy were excluded from the calculation.
Coeliac disease is a frequent cause of iron-deficiency anaemia, and antigliadin and antiendomysial antibody tests should be always performed in the diagnostic algorithm of anaemic patients.
尽管已知贫血可能是乳糜泻唯一的临床表现症状，但贫血患者中未被怀疑的乳糜泻患病率尚无相关数据。本研究旨在评估抗麦醇溶蛋白抗体和抗肌内膜抗体检测在贫血患者诊断流程中的临床实用性。
对200例连续的贫血患者进行抗麦醇溶蛋白抗体检测，抗体阳性者再进行抗肌内膜抗体检测。所有抗麦醇溶蛋白抗体和抗肌内膜抗体阳性的患者均接受肠道活检。
16例患者抗麦醇溶蛋白抗体阳性，其中10例抗肌内膜抗体也呈阳性。所有10例患者的空肠活检结果均符合乳糜泻（患病率为5%）。当计算中排除巨幼细胞贫血患者或因既往出血或对口服铁剂治疗有反应的小细胞贫血患者时，患病率升至8.5%。
乳糜泻是缺铁性贫血的常见病因，在贫血患者的诊断流程中应始终进行抗麦醇溶蛋白抗体和抗肌内膜抗体检测。
