Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy
Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy
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DOI：
10.1002/mus.20652
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发表时间：
2007-01-01
期刊：
影响因子：
3.4
通讯作者：
Vilardell-Tarres, Miquel
中科院分区：
文献类型：
--
作者：
Selva-O'Callaghan, Albert;Casellas, Francesc;Vilardell-Tarres, Miquel
乳糜泻通常与自身免疫性疾病相关，偶尔也有炎症性肌病患者的报道。我们的目的是确定炎症性肌病患者是否存在乳糜泻和与乳糜泻相关的抗体，并调查它们之间的关系。测定了51例炎性肌病患者血清抗麦胶蛋白、抗组织转谷氨酰胺酶和抗肌内膜抗体。研究HLA-DQ2和-DQ8等位基因以评估其互补诊断价值。对抗麦胶蛋白抗体水平中高的患者进行空肠活检。空肠组织学与乳糜泻一致的患者开始无麸质饮食。17例（31%）患者抗麦胶蛋白抗体阳性，包涵体肌炎患者抗麦胶蛋白抗体阳性明显高于皮肌炎患者（P < 0.001）。HLA-DQ2和/或-DQ8的阳性状态在抗麦胶蛋白阳性（75%和12.5%）或阴性（60%和15%）患者之间没有差异。五分之三的空肠活检诊断为乳糜泻，无麸质饮食后组织学正常。因此，乳糜泻在炎性肌病患者中比在普通人群中更为普遍。HLA-DQ2等位基因的阳性状态，已知在炎症性肌病患者中更常见，可以解释抗麦胶蛋白抗体在该人群中的高患病率。HLA-DQ2或-DQ8单倍型对炎性肌病患者乳糜泻的诊断价值有限。
Celiac disease is usually associated with autoimmune disorders and has occasionally been reported in patients with inflammatory myopathies. Our aim was to determine the presence of celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathies and to investigate their relationship. Serum antigliadin, anti-tissue transglutaminase, and antiendomysial antibodies were determined in 51 patients with inflammatory myopathies. HLA-DQ2 and -DQ8 alleles were studied to assess their complementary diagnostic value. Jejunal biopsy was performed in patients with moderate to high levels of antigliadin antibodies. Patients with jejunal histology consistent with celiac disease initiated a gluten-free diet. Seventeen patients (31%) were positive for antigliadin antibodies, which were significantly more frequent in patients with inclusion-body myositis than dermatomyositis (P < 0.001). Positive status to HLA-DQ2 and/or -DQ8 did not differ between antigliadin-positive (75% and 12.5%) or -negative (60% and 15%) patients. Three of five jejunal biopsies were diagnostic for celiac disease with histological normalization after a gluten-free diet. Thus, celiac disease is more prevalent in patients with inflammatory myopathies than in the general population. Positive status to HLA-DQ2 allele, which is known to be more frequent in patients with inflammatory myopathies, could explain the high prevalence of antigliadin antibodies in this population. The diagnostic value of HLA-DQ2 or -DQ8 haplotypes to detect celiac disease in patients with inflammatory myopathy is limited.