Prevalence and diagnostic significance of serological markers of celiac disease in patients with IgA nephropathy


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Background. Taking into account the results of experimental and clinical studies demonstrating potential pathogenetic relationships between IgA nephropathy (IgAN) and celiac disease (CD), the association of these diseases in terms of the prevalence and influence of CD on the clinical and laboratory course of IgAN is of scientific interest. It was noted that in patients with IgAN, the prevalence of CD reaches 3.6%. According to the literature, the presence of celiac antibodies in the blood aggravates the course of IgAN in the form of severe proteinuria, erythrocyturia, arterial hypertension and a decrease in eGFR, which reflects the activity of nephropathy and potentially accelerates the progression of chronic kidney disease. Objective. Determination of the prevalence of serological markers (SM) of CD in the blood serum of patients with IgAN and clarification of their diagnostic value in the clinical and laboratory picture of IgAN. Methods. A cross-sectional comparative and prospective study was carried out. The study included 50 patients with morphologically confirmed IgAN. The determination of serological markers of celiac disease (CDSM) in the blood serum was a special diagnostic method. As a result of a comprehensive survey, patients were divided into two groups were fored. The first group (n=10) - with IgAN and positive SM and the second one (n=40) - with IgAN and negative SM. Results. It has been established that the prevalence of CDSM among patients with IgAN was 20%. The most common were IgA antibodies to deamidated gliadin peptides. In patients with positive serum SM, nephropathy activity was associated with more severe proteinuria and arterial hypertension. No statistically significant differences in creatinine, eGFR, and erythrocyturia level could be identified. Conclusion. The results of this study confirm the fact that the presence of CDSM exacerbates the clinical course of IgAN. Despite the absence of typical gastrointestinal symptoms, characteristic disorders of the macro- and microstructures of the small intestinal mucosa, serological testing for the presence of CD markers can be considered as an additional diagnostic method and thus help expand therapeutic approaches to the management of patients with IgAN.

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作者简介

Maria Mantsaeva

Russian Medical Academy of Continuous Professional Education

Email: mariyamantsaeva@yandex.ru
Postgraduate Student, Department of General Medical Practice and Outpatient Therapy

A. Borisov

Russian Medical Academy of Continuous Professional Education; Burdenko Main Military Clinical Hospital

Department of General Medical Practice and Outpatient Therapy

S. Chernavsky

Russian Medical Academy of Continuous Professional Education; Burdenko Main Military Clinical Hospital

Department of General Medical Practice and Outpatient Therapy

A. Stremoukhov

Russian Medical Academy of Continuous Professional Education

Department of General Medical Practice and Outpatient Therapy

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