自身免疫性甲状腺疾病患者乳糜泻筛查:从研究到日常临床实践

Giuseppe Fanciulli, Paolo A Tomasi, Fabrizia Caucci, Elisabetta Lai, Franca Sanciu, Giuseppe Delitala
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摘要

在研究环境中进行的筛查程序表明,乳糜泻在自身免疫性甲状腺疾病患者中的患病率大约是普通人群的4-15倍,因此建议对自身免疫性甲状腺疾病患者进行常规乳糜泻筛查。然而,这些筛查项目的表现从未在日常临床实践中得到评估。我们邀请在本院就诊的新诊断的自身免疫性甲状腺疾病患者参加乳糜泻的血清学筛查。纳入231例患者,男女比8.89:1,平均年龄41.3±18.1岁,年龄范围7.1 ~ 80.5岁。诊断为乳糜泻的人数为0。我们的研究结果不支持在日常实践中对自身免疫性甲状腺疾病患者进行乳糜泻筛查的有用性,尽管在研究环境研究中获得了有利的结果。由于筛查是一项消耗资源的活动,对于患者和临床医生来说,我们建议在临床实践中采用筛查之前,对筛查的效果进行仔细评估。
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Screening for celiac disease in patients with autoimmune thyroid disease: from research studies to daily clinical practice.

Screening procedures performed in research-setting studies have shown that the prevalence of celiac disease in patients with autoimmune thyroid disease is approximately 4-15 times higher than the general population, thus suggesting that patients with autoimmune thyroid disease should be routinely screened for celiac disease. However, the performance of these screening programs has never been evaluated in everyday, clinical-practice setting. We invited newly diagnosed patients with autoimmune thyroid disease, seen at our Hospital, to participate in a serological screening for celiac disease. Two-hundred and thirty-one patients, female to male ratio 8.89:1, mean age 41.3 +/- 18.1 years, range 7.1-80.5 years were included. The number of diagnosed celiac disease was 0. Our results do not support the usefulness of a screening for celiac disease in patients with autoimmune thyroid disease in daily practice, despite the favorable results obtained in research-setting studies. Since screening is a resource-consuming activity, for both patients and clinicians, we suggest that a careful evaluation of the yield of a screening is always warranted before its adoption in the clinical practice.

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