Volta U, Molinaro N, De Franceschi L, Bianchi F B
Istituto di Clinica Medica Generale e Terapia Medica, Università di Bologna, Policlinico S. Orsola, Italy.
J Clin Gastroenterol. 1996 Jul;23(1):18-20. doi: 10.1097/00004836-199607000-00006.
Sera from 800 patients referred to our laboratory for celiac sprue screening were tested for IgA antiendomysial antibodies on human umbilical cord (HUC-EmA) and for IgA and IgG antigliadin antibodies (AGA) on rodent tissue by indirect immunofluorescence. Thirty-three patients (4.1%) were positive for at least one of the two antibodies; IgA HUC-EmA were found in 25 patients, whereas IgA and IgG AGA were detected in 19 and 24 subjects, respectively. Twenty-seven (82%) of the 33 patients with immunological markers showed sub-total or severe partial villous atrophy consistent with celiac sprue, whereas the remaining six cases had normal histological findings. None of 30 antibody-negative biopsied patients showed abnormalities of duodenal mucosa. Of the 27 newly diagnosed celiacs, only 21 (78%) were positive for IgA and/or IgG AGA, whereas IgA HUC-EmA were found in all but two cases (93%). In these two cases, positive only for IgG AGA, celiac sprue was associated with IgA deficiency. Our study proves that the routine use of IgA HUC-EmA increases celiac sprue findings by up to 15% when compared with AGA.
将800例转诊至我们实验室进行乳糜泻筛查的患者血清，通过间接免疫荧光法检测其针对人脐带的IgA抗肌内膜抗体（HUC-EmA）以及针对啮齿动物组织的IgA和IgG抗麦胶蛋白抗体（AGA）。33例患者（4.1%）至少有一种抗体呈阳性；25例患者检测到IgA HUC-EmA，19例和24例患者分别检测到IgA和IgG AGA。33例有免疫标志物的患者中，27例（82%）表现为符合乳糜泻的次全或严重部分绒毛萎缩，而其余6例组织学检查结果正常。30例抗体阴性的活检患者中，无一例十二指肠黏膜有异常。27例新诊断的乳糜泻患者中，仅21例（78%）IgA和/或IgG AGA呈阳性，而除2例（93%）外，其余均检测到IgA HUC-EmA。在这2例仅IgG AGA呈阳性的病例中，乳糜泻与IgA缺乏相关。我们的研究证明，与AGA相比，常规使用IgA HUC-EmA可使乳糜泻的检出率提高多达15%。
