Primer biliyer sirozda çölyak hastalığı birlikteliği

Sezgin Vatansever; Zehra Betül Paköz; Belkıs Ünsal

doi:10.19161/etd.455438

EN TR

Coexisting of coeliac disease in primary biliary cirrhosis

Abstract

Aim: Autoimmune disorders tend to show co-occurrence. Coeliac disease (CD) may accompany primary biliary cirrhosis (PBC) like other autoimmune diseases. In this study, we aimed to evaluate the prevalance of CD in PBC patients.

Materials and Methods: Two hundred and thirty-eight patients whom diagnosed as PBC between April 2006-December 2017 and 205 healthy volunteers as control group compared prospectively. AGA IgG, AGA IgA, EMA IgG and EMA IgA results evaluated. Duodenum biopsies were obtained in patients who had positive AGA an EMA results.

Results: Median age was 54.2+12 in PBC patients and 43.8+14.4 in control group. Sixteen of 238 PBC patients and 90 of 205 control were male. Four (1.7%) PBC patients had AGA and EMA positivity. None of PBC patients had symptoms for CD. Thirteen (5.46%) patients had AGA positivity with low titration. One (0.4%) healthy control had EMA and AGA positivity and there was no statistical difference between two groups (p=0.379). According to Marsh classification of duodenal biopsies we found one Marsh 1, one Marsh 2 and two Marsh 3 in PBS group. one control who had positive EMA and AGA results showed Marsh 3 in duodenal biopsies

Conclusion: PBC and CD may be associated. PBC patients who are seropositive for CD must be followed according to complications of CD. Gluten-free diet is required for these patients.

Keywords

Coeliac disease,primary biliary cirrhosis.

Primer biliyer sirozda çölyak hastalığı birlikteliği

Öz

Amaç: Otoimmun hastalıklar genel olarak birliktelik gösterme eğilimindedirler. Primer biliyer siroza (PBS) da diğer otoimmun hastalıkların yanı sıra çölyak hastalığı (ÇH) eşlik edebilmektedir. Bu çalışmada PBS’li hastalarda ÇH’nin prevalansı değerlendirildi.

Gereç ve Yöntem: Çalışmada Nisan 2006-Aralık 2017 tarihleri arasında tanı alan ve takipli olan 238 PBS’li hasta, kontrol grubu olarak alınan 205 sağlıklı gönüllü ile prospektif olarak karşılaştırıldı. Hastalarda Anti Gliadin IgA ve IgG (AGA), Anti Endomisyum IgA ve IgG (EMA) antikorları immunofloresans yöntemi ile bakıldı. Antikorları pozitif saptanan hastalardan duodenum ikinci kısmından biyopsi alındı.

Bulgular: Çalışmaya alınan 238 hastanın yaş ortalaması 54,2±12 olup 16’sı erkekti. Kontrol grubundaki 205 kişinin 115’i kadın (%56,1), 90’ı erkek ve yaş ortalaması 43,8±14,4’tü. PBS’li 4 hastada AGA ve EMA pozitifliği (%1,7) saptandı. PBS’li hastaların hiçbirinde ÇH semptomları yoktu. On üç (%5,46) hastada ise düşük titrede AGA pozitifliği saptandı. Kontrol grubundaki bir (%0,4) hastada EMA, AGA IgA ve IgG yüksek titrede pozitif saptandı ve PBS’li grup ile istatistiksel fark saptanmadı (p=0,379). PBS tanısı olan ve EMA, AGA pozitif saptanan dört hastanın biyopsisinde, bir hastada Marsh 1, bir hastada Marsh 2 ve iki hastada Marsh 3 ile uyumlu duodenum biyopsi bulguları saptandı. EMA ve AGA’sı pozitif olan kontrol grubundaki bir hastanın ince barsak biyopsisi ise Marsh 3 ile uyumluydu.

Sonuç: PBS ve ÇH, birbiri ile ilişkili olabilen hastalıklardır. PBS tanılı hastalarda, ÇH açısından seropozitif olan hastaların takibinin ÇH ve komplikasyonlarına de yönelik olması ve tanı konulan hastalara glutensiz diyetin başlanması gerekmektedir.

Anahtar Kelimeler

Çölyak hastalığı,primer biliyer siroz.

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Sezgin Vatansever
0000-0002-8413-5353
Türkiye

Zehra Betül Paköz ^*
0000-0001-5918-6178
Türkiye

Belkıs Ünsal
0000-0003-2816-9214
Türkiye

Yayımlanma Tarihi

20 Eylül 2019

Gönderilme Tarihi

28 Şubat 2018

Kabul Tarihi

11 Temmuz 2018

Yayımlandığı Sayı

Yıl 2019 Cilt: 58 Sayı: 3

DOI

https://doi.org/10.19161/etd.455438

IZ

https://izlik.org/JA73CP74JJ

Kaynak Göster

RIS / Bibtex

Vancouver

1.Sezgin Vatansever, Zehra Betül Paköz, Belkıs Ünsal. Primer biliyer sirozda çölyak hastalığı birlikteliği. ETD. 01 Eylül 2019;58(3):246-50. doi:10.19161/etd.455438