Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya30983Prevalence of gluten-sensitive celiac disease in women with reproductive dysfunctionBykovaSvetlana Vladimirovnasvetfox@yandex.ruParfenovAsfol'd Ivanovichasfold@mail.ruTetruashviliNana Kartlosovnatetrauly@mail.ruSabel'nikovaElena Anatol'evna-GudkovaRaisa Borisovna-KrumsL M-Vorob'evaNatal'ya Nikolaevna-RepinaEkaterina Aleksandrovna-VityazevaIrina Ivanovna-PetukhovaGalina Stefanovna-BykovaS VCentral Research Institute of Gastroenterology, Moscow-ParfenovA ICentral Research Institute of Gastroenterology, Moscow-TetruashviliN KAcad. V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Moscow-SabelnikovaE ACentral Research Institute of Gastroenterology, Moscow-GudkovaR BCentral Research Institute of Gastroenterology, Moscow-KrumsL MCentral Research Institute of Gastroenterology, Moscow-VorobyevaN NCentral Research Institute of Gastroenterology, Moscow-RepinaE AResearch Center for Endocrinology, Moscow-VityazevaI NResearch Center for Endocrinology, Moscow-PetukhovaG SMoscow Reproduction Center, Moscow-Central Research Institute of Gastroenterology, MoscowAcad. V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology, MoscowResearch Center for Endocrinology, MoscowMoscow Reproduction Center, Moscow15022012842313610042020Copyright © 2012, Consilium Medicum2012Aim. To determine prevalence of gluten-sensitive celiac disease (GSCD) in women with reproductive dysfunction (RD).
Material and methods. Tests for blood serum antibodies to tissue transglutaminase (ABtTG) of IgA class were made in 217 women with RD. Tests for antibodies to gliadin (ABG) were performed in 180 of them. Esophagogastroduodenoscopy (EGDS) with biopsy to verify GSCD was conducted in patients with elevated ABtTG. The control group consisted of 15 healthy females of a reproductive age.
Results. The examinees exhibited IgA ABtTG in the range 1 to 280 IU/ml, while 16 of them had elevated level - 50.2 ± 194 IU/ml, on the average. The controls had 0-10 IU/ml level of ABtTG, mean level 4.3±1.5 IU/ml. EGDS with duodenobiopsy was performed in 14 women. The examination of biopsies from small intestinal mucosa has detected pathohistological signs of celiac disease in 7 of 14 women. At the moment of the study two women with a history of spontaneous abortion were pregnant. Their ABtTG was 21.7 and 15.9 IU/mg, respectively, EGDS was not performed because of potential pregnancy complication but in view of possible celiac disease they received recommendations on aglutenic diet.
Conclusion. Incidence rate of GSCD in women with RD is 4,1%. Aglutenic diet in GSCD women with RD contributes to reproductive function recovery and normal outcome of pregnancy. Elevation of ABtTG titers in women with RD is an indication to histological examination of small intestinal mucosa to detect GSCD.gluten-sensitive celiac diseaseinfertilityspontaneous abortionamenorrheaantibodies to tissue transglutaminaserate of reproductive dysfunctionглютенчувствительная целиакиябесплодиеневынашивание беременностиаменореяантитела к тканевой трансглутаминазечастота нарушения репродуктивной функции[Парфенов А. И. Целиакия. Эволюция представлений о распространенности, клинических проявлениях и значимости этиотропной терапии. М.: Анахарсис; 2007.][Быкова С. В., Сабельникова Е. А., Парфенов А. И. и др. Репродуктивные расстройства у женщин с целиакией. Влияние этиотропной терапии. Экспер. и клин. гастроэнтерол. 2011; 2: 12-17.][Bykova S. V., Sabelnikova E. A., Parfenov A. I. et al. Reproductive disorders with celiac disease women. In: Materials of 14-th International celiac disease symposium 2011, June 2011, Oslo, Norway: 135.][Stazi A. V., Mantovani A. Celiac disease. Risk factors for women in reproductive age. Minerva Ginecol. 2000; 52 (5): 189-196.][Hadziselimovic F., Geneto R., Buser M. Celiac disease, pregnancy, small for gestational age: role of extravillous trophoblast. Fetal Pediatr Pathol. 2007; 26 (3): 125-134.][Di Simone N., Silano M., Castellani R. et al. Anti-tissue transglutaminase antibodies from celiac patients are responsible for trophoblast damage via apoptosis in vitro. Am. J. Gastroenterol. 2010; 105 (10): 2254-2261.][Bona G., Marinello D., Oderda G. Mechanisms of abnormal puberty in coeliac disease. Horm Res. 2002; 57 (Suppl. 2): 63-65.][Corrado F., Magazzu G., Sferlazzas C. Diagnosis of celiac disease in pregnancy and puerperium: think about it. Acta Obstetr. Gynecol Scand. 2002; 81 (2): 180-181.][Collin P., Vilska S., Heinonen P. K. et al. Infertil. Coeliac Dis. Gut 1996; 39 (3): 382-384.][Shamaly H., Mahameed A., Sharony A., Shamir R. Infertility and celiac disease: do we need more than one serological marker? Acta Obstetr. Gynecol. Scand. 2004; 83 (12): 1184-1188.][Molteni N., Bardella M. T., Bianchi P. A. Obstetric and gynecological problems in women with untreated celiac sprue. J. Clin. Gastroenterol. 1990; 12 (1): 37.][Tursi A., Giorgetti G., Brandimarte G., Elisei W. Effect of gluten-free diet on pregnancy outcome in celiac disease patients with recurrent miscarriages. Dig. Dis. Sci. 2008; 53 (11): 2925-2928.]