Serum positivity of serum anti-tissue transglutaminase immunoglobulin A antibodies in Japanese children with inflammatory bowel disease
Serum positivity of serum anti-tissue transglutaminase immunoglobulin A antibodies in Japanese children with inflammatory bowel disease
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DOI：
10.1111/ped.15485
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发表时间：
2023-01-01
影响因子：
1.4
通讯作者：
Nakayama，Yoshiko
中科院分区：
文献类型：
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作者：
Kurasawa，Shingo;Sado，Tomomitsu;Nakayama，Yoshiko
背景血清抗组织转氨酶免疫球蛋白A抗体（tTG ‐ IgA）是乳糜泻（CeD）的筛查试验。近年来，有几个报告合并炎症性肠病（IBD）和CeD的儿童。本研究的目的是研究日本儿童tTG-IgA抗体的阳性率，以及IBD和CeD是否同时发生。MethodsWe检查了tTG-IgA作为有症状的IBD（病例）和无IBD（对照，非IBD）的儿科患者的CeD筛查试验。tTG ‐ IgA水平为10 U/mL或更高的患者被视为阳性。所有患者常规活检标本取自十二指肠的第二部分和球，并进行了组织学评估的基础上Marsh classification.Results31例IBD组和53例非IBD组。5例（5.9%）tTG ‐ IgA阳性，阳性病例的中位滴度为12.3 U/mL（10.2 - 41.7）。IBD组1例患者（3.2%）和非IBD组4例患者（7.8%）tTG ‐ IgA阳性。所有病例均无CeD的组织学特征。tTG ‐ IgA阳性组和阴性组之间在年龄、性别、症状和实验室检查方面没有统计学显著差异。IBD和非IBD组中tTG-IgA阳性的患者在小麦消耗后表现出症状。ConclusionsWe确定了一名tTG-IgA抗体阳性的患者，该患者因小麦摄入而出现腹部症状，表明亚临床CeD。需要进一步研究以阐明日本儿童中IBD和CeD的共同发生。
BackgroundSerum anti‐tissue transglutaminase immunoglobulin A antibody (tTG‐IgA) is a screening test for celiac disease (CeD). In recent years, there have several reports of combined inflammatory bowel disease (IBD) and CeD in children. The purposes of this study are to research the positivity of the tTG‐IgA antibody in Japanese children, and whether IBD and CeD co‐occur.MethodsWe examined tTG‐IgA as a screening test for CeD in symptomatic pediatric patients with IBD (cases) and those without IBD (controls, non‐IBD). Those with tTG‐IgA levels of 10 U/mL or higher were considered positive. All patients had routine biopsy specimens taken from the second part and bulbus of the duodenum, and were evaluated histologically based on the Marsh classification.ResultsThirty‐one patients in the IBD group and 53 patients in the non‐IBD group were included. The tTG‐IgA was positive in five cases (5.9%) and median titer of positive cases was 12.3 U/mL (10.2–41.7). One patient in the IBD group (3.2%) and four patients in the non‐IBD group (7.8%) were positive for tTG‐IgA. No cases showed histological features of CeD. There were no statistically significant differences in age, sex, symptoms and laboratory tests between the tTG‐IgA positive and negative groups. Patients among the IBD and the non‐IBD groups that were tTG‐IgA positive demonstrated symptoms after wheat consumption.ConclusionsWe identified a patient who was positive for tTG‐IgA antibodies who experienced abdominal symptoms due to wheat ingestion, indicative of subclinical CeD. Further investigation is needed to clarify the co‐occurrence of IBD and CeD among Japanese children.