Genco GENCDAL, Cenk Emre MERAL, Elif AZARSIZ, Güzide AKSU, Fulya GÜNŞAR, Ulus Salih AKARCA

Primer Biliyer Kolanjit ve Otoimmün Karaciğer Hastalıklarında Çölyak Hastalığı Prevalansı

Giriş: Çölyak hastalığı (ÇH), glutene maruz kalındığında oluşan bir ince bağırsak hastalığıdır. ÇH, dermatitis herpetiformis, otoimmün tiroid hastalığı, tip 1 diabetes mellitus ve otoimmün karaciğer hastalıkları ile sıklıkla birliktelik gösterir. Otoimmün hepatit (OİH) ve primer biliyer kolanjit (PBK) en sık görülen otoimmün karaciğer hastalıklarıdır. Bu çalışmada, hastanemizde PBK, OİH ve PBK + OİH overlap tanılı hastalarda ÇH sıklığını araştırdık.Metod: PBK, OİH ve OİH + PBK overlap tanılı hastalar çalışmaya dahil edilmiştir.ÇH tanısı spesifik serum antikorları ve spesifik duodenal biyopsi bulguları ile konulmuştur.Sonuçlar: PBK (n = 47; F:% 95.7; yaş: 53 ± 10 yıl), OİH (n = 23; F:% 100; yaş: 48 ± 12 yıl) ve OİH + PBK overlap (n = 29, F:% 96.6, yaş: 51 ± 10.9 yıl) tanılı toplam 99 hasta çalışmaya dahil edilmiştir. PBC grubundaki üç (% 6.4),OİH grubunda 2 (% 8.7), PBK+OİH overlap grubunda 1(% 3) hastaya serolojik ve histolojik bulgulara dayanarak ÇH tanısı konuluştur. Tartışma: Tek başına anti-gliadin antikoru (AGA) pozitifliği veya tek başına anti-endomisyum antikoru (EMA) pozitifliği ÇH tanısı için yeterli değildir. Daha kesin tanı için, ÇH taramasında her 2 testin birlikte kullanılmasını ve ÇH spesifik antikorların pozitif tespit edildiği olgularda, tanının duodenum biyopsiyle desteklenmesini öneriyoruz.

Anahtar Kelimeler:

Çölyak hastalığı, primer biliyer kolanjit, otoimmün karaciğer hastalığı

Prevalence of Coeliac Disease in Autoimmune Liver Disease and Primary Biliary Cholangitis

Background: Coeliac disease (CD) is a small bowel disease, which occurs upon exposure to dietary gluten. CD is often associated with dermatitis herpetiformis, autoimmune thyroid disease, type 1 diabetes mellitus and autoimmune liver diseases. Autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) are the most common autoimmune liver diseases. In this study, we investigated the prevalence of CD in patients with PBC, AIH and overlapping PBC + AIH in our Hospital.Methods: Ninety-nine patients with PBC, AIH and overlapping AIH + PBC were included in this study. Specific serum antibodies and specific duodenal biopsy results are used for diagnosis of CD.Results: Ninety-nine patients with PBC (n = 47; F: 95.7%; age: 53 ± 10 years), AIH (n = 23; F: 100%; age: 48 ± 12 years) and overlapping AIH + PBC (n = 29;F : 96.6%; age: 51 ± 10.9 years) were included in this study.Three patients (6.4%) in the PBC group, one patient (3%) in the PBC + AIH group and two patients (8.7%) in the AIH group were serologically and histologically diagnosed with CD. Conclusion: Anti-gliadine antibody (AGA) positivity or anti-endomysium antibody (EMA) positivity alone was not sufficient for CD diagnosis. We suggest using both tests for CD screening to achieve more accurate results. In cases of positive CD-specific antibody results, we advise confirming the diagnosis by histopathological examination of duodenal biopsies.

Keywords:

Coeliac disease, Autoimmune hepatitis, Primary biliary cholangitis,

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