THE ASSOCIATION OF CELIAC DISEASE WITH IDIOPATHIC INFERTILITY IN CENTRAL ANATOLIA REGION

Yıl 2021, , 19 - 24, 08.02.2021

Sümeyra Özberk Eser Kılıç , Gülten Can Sezgin , Mehmet Yücesoy

https://doi.org/10.17517/ksutfd.774594

Öz

Aim: Celiac Disease (CD) is an inflammatory autoimmune disease that occurs in the small intestine of genetically predisposed individuals after gluten intake. CD leads to several gynecological and obstetrical problems. We aimed to investigate the prevalence of CD in patients with the diagnosis of idiopathic infertility in Central Anatolia.
Patients and Methods: The study included 30 female patients who had the diagnosis of idiopathic infertility in the Erciyes UniversityFaculty of Medicine, gynecology and obstetrics clinic and 33 healthy women with at least one healthy pregnancy. The levels of AGA IGG/IGM, EMA, tTG, and IgG/IgM antibodies were measured in all patients and the study group. Upper gastrointestinal endoscopy and duodenal biopsy were performed for the individuals with a positive test result.
Results: There was no significant difference in the presence of anemia, age, and body mass index between the groups. While AGA IGA was positive in four patients and AGA IGG was only positive in one patient in the patient group, AGA IGA was positive in three patients in the control group. In the control group, only one patient had a positive (EMA) test result; however, there was no positive result in any of the patients in the study group. TTG IgA antibodies were negative in both groups. Two patients had positive test in terms of TTG IgG in the control group. There was no statistically significant difference in terms of serological tests in both groups.
Conclusion: The prevalence of CD in idiopathic infertile patients was similar to the control group. Further studies are needed to evaluate this relationship in this cohort.

Anahtar Kelimeler

antibodies, celiac disease, infertility

İç Anadolu Bölgesinde Çölyak Hastalığının İdiyopatik İnfertilite ile İlişkisi

Öz

Amaç: Çölyak Hastalığı (ÇH) genetik yatkınlığı olan bireylerin glüten alımından sonra ince bağırsaklarında ortaya çıkan inflamatuar bir otoimmün hastalıktır. CD birçok jinekolojik ve obstetrik soruna yol açar. İç Anadolu'da idiyopatik infertilite tanısı alan hastalarda ÇH prevalansını araştırmayı amaçladık.
Hastalar ve Yöntemler: Çalışmaya Erciyes Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum kliniğinde idiyopatik infertilite tanısı alan 30 kadın hasta ve en az bir sağlıklı gebeliği olan 33 sağlıklı kadın dahil edildi. Tüm hastalarda ve çalışma grubunda antigliadin antikor (AGA) IGG / IGM, anti-endomysial antikor (EMA), anti-doku transglütaminaz antikorları (tTG) ve IgG / IgM antikor düzeyleri ölçüldü. Test sonucu pozitif olan kişilere üst gastrointestinal endoskopi ve duodenal biyopsi yapıldı.
Bulgular: Gruplar arasında anemi varlığı, yaş ve vücut kitle indeksi açısından anlamlı fark yoktu. Hasta grubundaki dört hastada AGA IGA pozitif, bir hastada AGA IGG sadece pozitif iken, kontrol grubundaki üç hastada AGA IGA pozitifti. Kontrol grubunda sadece bir hasta pozitif (EMA) test sonucuna sahipti; ancak çalışma grubundaki hastaların hiçbirinde olumlu sonuç alınamadı. tTG IgA antikorları her iki grupta da negatifti. Kontrol grubunda iki hastada tTG IgG testi pozitif çıktı. Her iki grupta serolojik testler açısından istatistiksel olarak anlamlı fark yoktu.
Sonuç: İdiyopatik infertil hastalarda ÇH prevalansı kontrol grubuna benzerdi. Bu kohortta bu ilişkiyi değerlendirmek için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

antibody, çölyak hastalığı, infertilite

Kaynakça

• Referans 1 Küçükazman M, Ata N, Dal K, Nazlıgül Y. Çölyak Hastalığı. Dirim Tıp Gazetesi 2008;83:85-92
• Referans 2 Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003;163(3):286-92.
• Referans 3 West J, Logan RF, Hill PG, et al. Seroprevalence, correlates, and characteristics of undetected coeliac disease in England. Gut. 2003;52(7):960-5.
• Referans 4 Book L, Neuhausen SL. Prevalence of Celiac Disease Among Relatives of Sib Pairs With Celiac Disease in US Families. Am J Gastroenterol. 2003;98(2):377-81.
• Referans 5 Cramer DW, Walker AM, Schiff I. Statistical methods in evaluating the outcome of infertility therapy. Fertility and sterility. 1979;32(1):80-6.
• Referans 6 Taşçı E, Bolsoy N, Kavlak O, Yücesoy F. [Marital adjustment in infertile women]. J Turk Soc Obstet Gynecol 2008;5(2):105-110
• Referans 7 Meloni G, Dessole S, Vargiu N, et al. The prevalence of coeliac disease in infertility. Human Reproduction. 1999;14(11):2759-61.
• Referans 8 McCann J, Nicholls D, Verzin J. Adult coeliac disease presenting with infertility. Ulster Med J. 1988;57(1):88.
• Referans 9 Collin P, Vilska S, Heinonen P, et al. Infertility and coeliac disease. Gut. 1996;39(3):382-4.
• Referans 10 Bradley RJ, Rosen MP. Subfertility and gastrointestinal disease:‘unexplained’is often undiagnosed. Obstetrical & gynecological survey. 2004;59(2):108-17.
• Referans 11 Tersigni C, Castellani R, De Waure C, et al. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Human reproduction update, 2014; 20(4), 582-593.
• Referans 12 Ascher H, Krantz I, Kristiansson B. Increasing incidence of coeliac disease in Sweden. Arch Dis Child. 1991;66(5):608-11.
• Referans 13 Catassi C, Rätsch I, Fabiani E, et al. Coeliac disease in the year 2000: exploring the iceberg. The Lancet. 1994;343(8891):200-3.
• Referans 14 Mäki M, Kallonen K, Lahdeaho ML, et al. Changing pattern of childhood coeliac disease in Finland. Acta Paediatrica. 1988;77(3):408-12.
• Referans 15 Kolho KL, Färkkilä M, Savilahti E. Undiagnosed coeliac disease is common in Finnish adults. Scand J Gastroenterol. 1998;33(12):1280-3.
• Referans 16 Gursoy S, Guven K, Simsek T, et al. The prevalence of unrecognized adult celiac disease in Central Anatolia. J Clin Gastroenterol. 2005;39(6):508-11.
• Referans 17 Fortunato F, Martinelli D, Prato R, et al. Results from Ad Hoc and Routinely Collected Data among Celiac Women with Infertility or Pregnancy Related Disorders: Italy, 2001–2011. Sci World J. 2014;2014.
• Referans 18 Shamaly H, Mahameed A, Sharony A, Shamir R. Infertility and celiac disease: do we need more than one serological marker? Acta obstet Gynecol Scand. 2004;83(12):1184-8.
• Referans 19 Greco L, Veneziano A, Di Donato L, et al. Undiagnosed coeliac disease does not appear to be associated with unfavourable outcome of pregnancy. Gut. 2004;53(1):149-51.
• Referans 20 Sharshiner R, Romero ST, Bardsley TR, et al. Celiac disease serum markers and recurrent pregnancy loss. J Reprod Immunol. 2013;100(2):104-8.
• Referans 21 Kolho KL, Färkkilä M, Savilahti E. Undiagnosed coeliac disease is common in Finnish adults. Scand J Gastroenterol. 1998;33(12):1280-3.
• Referans 22 Jackson JE, Rosen M, McLean T, et al. Prevalence of celiac disease in a cohort of women with unexplained infertility. Fertility and sterility. 2008;89(4):1002-4.
• Referans 23 Tiboni GM, De Vita MG, Faricelli R, et al. Serological testing for celiac disease in women undergoing assisted reproduction techniques. Hum Reprod. 2006;21(2):376-9.
• Referans 24 Hogen Esch CE, Van Rijssen MJ, Roos A, et al. Screening for unrecognized coeliac disease in subfertile couples. Scand J Gastroenterol. 2011;46(12):1423-8.
• Referans 25 Van Heel D, West J. Recent advances in coeliac disease. Gut. 2006;55(7):1037-46.
• Referans 26 Kumar A, Meena M, Begum N, et al. Latent celiac disease in reproductive performance of women. Fertility and sterility. 2011;95(3):922-7.