Human leukocyte antigen-DQ2 homozygosity and the development of refractory Celiac disease and enteropathy-associated T-cell lymphoma

被引:139
作者
Al-Toma, A
Goerres, MS
Meijer, JWR
Peña, AS
Crusius, JBA
Mulder, CJJ
机构
[1] Vrije Univ Amsterdam Med Ctr, Dept Gastroenterol, NL-1005 MB Amsterdam, Netherlands
[2] Rijnstate Hosp, Dept Gastroenterol, Arnhem, Netherlands
[3] Rijnstate Hosp, Dept Pathol, Arnhem, Netherlands
[4] Vrije Univ Amsterdam Med Ctr, Dept Pathol, Immunogenet Lab, NL-1005 MB Amsterdam, Netherlands
关键词
D O I
10.1016/j.cgh.2005.12.011
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Celiac disease (CD) is a common gluten-sensitive enteropathy associated with human leukocyte antigen (HLA)-DQ2 and HLA-DQ8. The aim of this study was to determine if a particular HLA-DQ subtype predisposes to complications such as refractory CD with (RCD II) or without aberrant T cells (RCD I), and enteropathy-associated T-cell lymphomas (EATL). Methods: Molecular HLA-DQ typing was performed on 43 RCD I, 43 RCD II, and 30 EATL patients, and compared with age-matched groups of 121 patients with histologically defined uncomplicated CD and 183 healthy controls. All individuals were Dutch Caucasians and were at least 21 years of age. Results: HLA-DQ2 was present in 79% of RCD I, 97.7% of RCD II, and 96.6% of EATL patients. The differences were significant when compared with 28.9% in controls but not with 91.7% in uncomplicated CD. Homozygosity for HLA-DQ2 was observed in 25.5% of RCD I, 44.1% of RCD II, and 53.3% of EATL patients vs 20.7% of uncomplicated CD patients and 2.1% of controls. HLA-DQ8 was present in 10.7% of CD, 16.2% of RCD I, 9.3% of RCD II, and 6.6% of EATL patients vs 20.2% of controls. Conclusions: Homozygosity for HLA-DQ2 is associated with RCD II and EATL. Early identification of HLA-DQ2 homozygous CD patients may help to recognize CD patients at risk for developing these severe complications.
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页码:315 / 319
页数:5
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