标题： The prevalence of celiac disease in adult Chinese patients with diarrhea predominant irritable bowel syndrome of China, a prospective, controlled, cohort study.
作者： Kou, Guanjun; Guo, Jing; Zuo, Xiuli; Li, Changqing; Liu, Chao; Ji, Rui; Liu, Han; Wang, Xiao; Li, Yanqing
作者机构：[ Kou, Guanjun; Kou G] Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shan 更多
来源： Journal of digestive diseases
摘要： BACKGROUND: Celiac disease (CD) is a chronic inflammatory enteropathy with a symptom spectrum similar to that of irritable bowel syndrome (IBS). CD is a common, but largely undiagnosed, condition in Western countries. However, it is extremely rare among Chinese people, and few studies have evaluated its prevalence in China. OBJECTIVE: To determine the prevalence of CD in IBS patients diagnosed using the Rome III criteria in North China. METHODS: This was a single-center, prospective, controlled cohort study performed in Qilu Hospital involving 246 IBS patients and 246 healthy controls. Blood samples were drawn for assessment of serum tTg-IgA. Patients with a positive tTg-IgA test result were subjected to probe-based confocal laser endomicroscopy (pCLE) and duodenal biopsy to confirm CD. RESULTS: Twelve patients with IBS (4.84%) and two healthy controls (0.81%) were positive for serum tTG-IgA. Of them, five IBS patients underwent pCLE and targeted biopsy; all were confirmed to have CD. After implementation of a gluten-free diet, seven serologically positive IBS patients showed clinical improvement, for a minimum prevalence of CD among IBS patients of 2.85%. CONCLUSION: CD is not rare in Chinese people, particularly among those with IBS. Therefore, CD should receive greater attention in clinical practice in China.