Improving the diagnosis of coeliac disease in anaemic women
Improving the diagnosis of coeliac disease in anaemic women
复制标题
改善贫血女性乳糜泻的诊断
DOI：
10.1111/j.1365-2141.2000.02451.x
复制
发表时间：
2000
影响因子：
6.5
通讯作者：
R. Harvey
中科院分区：
文献类型：
--
作者：
D. J. Unsworth;R. J. Lock;R. Harvey
大多数新诊断的乳糜泻患者患有缺铁性贫血。隐匿性面筋肠病很常见。我们观察了献血者志愿者，他们无法献血，因为他们意外地被发现患有贫血，以确定腹部疾病的发生率，以及这种诊断是否被常规考虑。在4个 月的时间里，110名 973献血志愿者被发现患有贫血，其中1%(1197名女性和183名男性)被发现。在483份用于检测的贫血样本中，有32份的IgA抗内膜肌抗体呈阳性。在32例血清阳性病例中，除3例外，其余均发现有小细胞性贫血。32名志愿者中有25名同意接受内窥镜小肠活组织检查，其中22名(88%)具有典型的腹部疾病的组织学表现。22例中有21例是女性。在我们的干预之前，从来没有对这些妇女进行过乳糜泻可能性的调查。通过选择贫血对象进行筛查，与非贫血志愿者(0%)相比，有更高的检出率(6%以上)。在研究人群中有更多的贫血女性(贫血女性与贫血男性的比例为5·5：1)。我们发现，尤其是在贫血的月经妇女中，乳糜泻没有被发现，也没有得到充分的研究。
The majority of patients with newly diagnosed coeliac disease have iron deficiency anaemia. Occult gluten enteropathy is common. We looked at blood donor volunteers, unable to donate because they were unexpectedly found to be anaemic, to determine the incidence of coeliac disease and whether this diagnosis is routinely considered. In a 4 month period, 110 973 blood donor volunteers were seen and 1% (1197 women and 183 men) were found to be anaemic. Of 483 anaemic samples selected for testing, 32 out of 483 were positive for IgA anti‐endomysial antibodies. Microcytic anaemia was found in all but three of the 32 seropositive cases. Twenty‐five out of 32 volunteers agreed to have endoscopic small bowel biopsies and 22 out of 25 (88%) had the typical histological appearances of coeliac disease. Twenty‐one out of 22 cases were women. In no case prior to our intervention had these women been investigated for the possibility of coeliac disease. By selecting anaemic subjects for screening, there was an improved detection rate (over 6%) compared with non‐anaemic volunteers (0%). There were far more anaemic women in the study population (ratio of anaemic women to anaemic men 5·5:1). We show that, especially in anaemic menstruating women, coeliac disease is unrecognized and under‐investigated.