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Gluten sensitive enteropathy in patients with iron deficiency anemia of unknown origin

World Journal of Gastroenterology 2008年第48期14卷 7381-7385页

作者： Farhad Zamani Mehdi Mohamadnejad Ramin Shakeri Afsaneh Amiri Safa Najafi Seyed Meysam Alimohamadi Seyed Mohamad Tavangar Ardeshir Ghavamzadeh Reza Malekzadeh Gastrointestinal and Liver Disease Research Centre Iran University of Medical Sciences Digestive Disease Research Centre Tehran University of Medical Sciences Hematology Oncology BMT research Center Tehran University of Medical Sciences Department of Pathology School of Medicine Tehran University of Medical Sciences

AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.

关键词： Gluten sensitive enteropathy Iron deficiency anemia anti-tissue transglutaminase antibody anti-endomysial antibody Gluten free diet

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Thiol/disulphide homeostasis in celiac disease

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2017年第2期8卷 120-126页

作者： Mustafa Kaplan Ihsan Ates Mahmut Yuksel Yasemin Ozderin Ozin Murat Alisik Ozcan Erel Ertugrul Kayacetin Department of Gastroenterology Turkey Yuksek Ihtisas Training and Research Hospital Department of Internal Medicine Ankara Numune Training and Research Hospital Department of Biochemistry Yildirim Beyazit University Medical Faculty

AIM To determine dynamic thiol/disulphide homeostasis in celiac disease and to examine the associate with celiac autoantibodies and gluten-free *** Seventy three patients with celiac disease and 73 healthy volunteers were enrolled in the study. In both groups, thiol/disulphide homeostasis was examined with a new colorimetric method recently developed by Erel and Neselioglu. RESULTS In patients with celiac disease, native thiol(P = 0.027) and total thiol(P = 0.031) levels were lower, while disulphide(P antibody-positive, disulphide/native thiol ratio was observed higher compared to the patients with autoantibody-negative(P antibodies, and native thiol, total thiol levels and native thiol/total thiol ratio, while a positive correlation is observed between disulphide, disulphide/native thiol and disulphide/total thiol *** This study is first in the literature which found that the patients with celiac disease the dynamic thiol/disulphide balance shifts through disulphide form compared to the control group.

关键词： anti-gliadin antibodies anti-tissue transglutaminase antibody Gluten-free diet Oxidative stress Thiol oxidation

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