Gluten-sensitivity celiac disease as one of the rare causes of recurrent miscarriage
- Authors: Tetruashvili N.K1, Bykova S.V2, Agadzhanova A.A1, Parfenov A.I2, Sabelnikova E.A2, Krums L.M2, Gudkova R.B2
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Affiliations:
- Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Moscow Clinical Scientific Center
- Issue: No 11 (2014)
- Pages: 57-61
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/247280
- ID: 247280
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Abstract
The present-day study of gluten-sensitivity celiac disease (GCD) could establish the autoimmune nature of small bowel mucosal inflammation and its relationship to reproductive disorders in women of childbearing age. Objective. To determine the rate of GCD, as well as its clinical symptoms in women with recurrent miscarriage. Subject and methods. The investigation enrolled 217 women (mean age 30.5±5.8 years) with recurrent miscarriage who had been followed up at the Research Center for Obstetrics, Gynecology, and Perinatology jointly with the Central Research Institute of Gastroenterology. The enzyme-linked immunosorbent assay was used to study IgA-class anti-α-gliadin and anti-tissue transglutaminase (anti-tTG) antibodies for the serological verification of GCD. Its diagnosis was histologically verified in the presence of elevated antibody levels, by applying 3-5 small bowel mucosal fragments obtained from the distal duodenum during esophagogastroduodenoscopy. Results. Examination of the 217 women with recurrent miscarriage established the diagnosis of GCD in 9 (4.1%) of them, which exceeds the population-based value (0.6-1%). The intestinal manifestations of the disease, weak- ness, and decreased working capacity were significantly more frequently encountered in the women with the verified diagnosis of GCD than in those with normal antibody levels. The clinical manifestations of malabsorption did not significantly differ in both groups. A gluten-free diet (GFD) could normalize intestinal function in the women with recurrent miscarriage and successfully prolong pregnancy during therapy. Conclusion. Among the women with recurrent miscarriage, the GCD detection rate of 4.1% significantly exceeds the population-based value (0.6%). GFD used in celiac disease patients having reproductive disorders contributed to recovered reproductive function and a favorable pregnancy outcome. Higher anti-tTG antibody titers in women with reproductive disorders are an indication for the histological examination of the small bowel mucosa in order to identify gluten-sensitivity celiac diseases.
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About the authors
N. K Tetruashvili
Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: tetrauly@mail.ru
S. V Bykova
Moscow Clinical Scientific Center
A. A Agadzhanova
Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
A. I Parfenov
Moscow Clinical Scientific Center
E. A Sabelnikova
Moscow Clinical Scientific Center
L. M Krums
Moscow Clinical Scientific Center
R. B Gudkova
Moscow Clinical Scientific Center
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