乳糜泻和疱疹样皮炎男性患者的临床和组织学比较:一项十年回顾性研究。

Q2 Medicine
Arquivos de Gastroenterologia Pub Date : 2025-07-21 eCollection Date: 2025-01-01 DOI:10.1590/S0004-2803.24612025-016
Lorete Maria da Silva Kotze, Eloisa Medeiros Nisihara, Luiz Roberto Kotze, Renato Nisihara
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引用次数: 0

摘要

背景:麸质相关疾病,如乳糜泻(CD)和疱疹样皮炎(DH)是由麸质不耐受引发的自身免疫性疾病。乳糜泻表现为广泛的临床症状,包括肠道和肠外,而DH是与乳糜泻相关的皮肤表现。乳糜泻和DH的临床表现在男性和女性之间可能有所不同。目的:本研究旨在描述男性CD和DH诊断时的临床特征和组织学表现,比较两者的异同。方法:本回顾性研究纳入了巴西库里提巴一家专业私人诊所诊断为乳糜泻或DH的男性患者。该研究涉及对患者临床图表的回顾,并在2014年1月至2024年1月的10年期间进行。乳糜泻的诊断是基于阳性的血清学检查和十二指肠活检,并按Marsh分级分级。所有患者在CD诊断前均通过临床评估和皮肤活检直接免疫荧光证实DH诊断。所有病人都在摄入谷蛋白。结果:本研究分析了75例男性患者,其中CD 57例,DH 18例。腹泻在乳糜泻患者中更为普遍,而骨质疏松仅在乳糜泻组中观察到。轻度肠病(Marsh I或Marsh II)占34.7%,较常与DH相关。在两组中,Marsh III型占多数,占65.3%。乳糜泻和DH患者表现出相似的症状。结论:男性乳糜泻患者与DH患者在临床和组织学表现上无显著差异,只是乳糜泻患者腹泻发生率较高。建议所有DH患者进行十二指肠活检。背景:乳糜泻和疱疹样皮炎有共同的遗传背景,但经常被误诊。背景:近年来,由于意识的提高和血清学检测的改进,两种情况下轻度肠病的诊断都有所增加。•女性受到的影响和研究更多。很少有针对男性的研究。•总体而言,两种疾病的临床表现相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CLINICAL AND HISTOLOGICAL COMPARISON OF CELIAC DISEASE AND DERMATITIS HERPETIFORMIS IN MALE PATIENTS: A TEN-YEAR RETROSPECTIVE STUDY.

Background: Gluten - related diseases, such as celiac disease (CD) and dermatitis herpetiformis (DH) are autoimmune conditions triggered by gluten intolerance. CD manifests with a broad spectrum of clinical symptoms, both intestinal and extraintestinal, while DH is a cutaneous manifestation associated with CD. The clinical manifestations of both CD and DH can vary between men and women.

Objective: This study aimed to describe the clinical profiles and histological findings at the time of diagnosis in men with CD and DH, comparing the differences and similarities between the findings.

Methods: This retrospective study included male patients diagnosed with CD or DH from a specialized private clinic in Curitiba, Brazil. The study involved a review of patients' clinical charts and was carried out over a ten-year period, from January 2014 to January 2024. CD diagnosis was based on positive serological tests and duodenal biopsies graded by Marsh classification. All patients had DH diagnosis was confirmed through clinical assessment and direct immunofluorescence on skin biopsies before CD diagnosis. All patients were ingesting gluten.

Results: The study analyzed 75 male patients, 57 with CD and 18 with DH. Diarrhea was significantly more prevalent in CD patients, while osteoporosis was exclusively observed in the CD group. Mild enteropathy (Marsh I or Marsh II), accounting for 34.7%, was more commonly associated with DH. In both groups, Marsh III predominated, representing 65.3% of cases. Men with CD and DH displayed similar symptoms.

Conclusion: There were no significant differences in clinical and histological findings between male patients with CD and DH, apart from a higher incidence of diarrhea in CD patients. Duodenal biopsies are recommended for all DH patients.

Background: • Celiac disease and dermatitis herpetiformis shared genetic background and are frequently underdiagnosed.

Background: • Diagnoses of mild enteropathy in both conditions have increased in recent years due to better awareness and improved serological testing.

Background: • Women are more affected and studied. There are few studies in men.

Background: • Overall, clinical presentations were similar between the two diseases.

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来源期刊
Arquivos de Gastroenterologia
Arquivos de Gastroenterologia Medicine-Gastroenterology
CiteScore
2.00
自引率
0.00%
发文量
109
审稿时长
9 weeks
期刊介绍: The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.
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