T. C. Sağlik bakanliği haydarpaşa numune eğİTİm ve araştirma hastanesi İÇ hastaliklari kliNİĞİ

ÖZET 

 

Çölyak hastalığı insanlarda en sık görülen otoimmun karakterli ve 

besin kökenli bir ince barsak hastalığıdır. Son yıllarda serolojik tarama 

metodlarının tespiti, genetik ve moleküler gelişmeler neticesinde 

hastalığın düşünülenden çok daha sık görüldüğü anlaşılmıştır. 

Daha önce yapılan çalışmalarda tip 1 diabetes mellitus, otoimmun 

tiroiditis, irritabl barsak sendromu olan hastalarda çölyak hastalığı 

normal popülasyona göre artmış olarak bulunmuş ve bu hastalarda 

tarama yapılması gerekliliği belirtilmiştir. Yine idiopatik transaminaz 

yüksekliği, gelişme geriliği, gecikmiş puberte, infertilite, demir eksikliği 

anemisi, dental enamel kayıplarında, otoimmun endokrinopatiler, 

osteoporozlu hastalar ve çölyak hastalarının birinci ve ikinci derece 

akrabalarında da çölyak hastalığının taranmasının gerekliliği 

bildirilmiştir. 

Vitiligo epidermiste melanosit kaybına bağlı olarak gelişen beyaz 

renkli yama tarzında maküler lezyonlarla karakterize depigmentasyonla 

seyreden otoimmun bir hastalıktır. Yine daha önce yapılan çalışmalarda 

vitiligo hastalarında alopesi areata, diabetes mellitus, pernisyöz anemi, 

Addison hastalığı, Hashimato tiroditi ve otoimmun tirodit sıklığının 

arttığı ve normal popülasyondan daha sık görüldüğü belirtilmiştir. 

Biz bu çalışmamızda vitiligo hastalığının çölyak hastalığı ile 

ilişkisini araştırdık. Çalışmaya klinik olarak vitiligo tanısı konan 33 

kadın 48 erkek toplam 81 hasta alındı. Sağlıklı hastane personeli ve 

hastaların sağlıklı yakınlarından oluşan yaş ve cinsiyeti hasta grubu ile 

uyumlu 37 kadın ve 51 erkekten oluşan toplam 88 kişilik kontrol grubu 

oluşturuldu. Her iki grupta da IgA EMA ve IgA tTG antikorları 

 

61

araştırıldı. Çalışma grubundan bir olguda IgA EMA ve IgA tTG 

antikorları pozitif bulunurken, kontrol grubundan bir olguda ise IgA 

EMA pozitif saptanırken aynı olguda IgA tTG şüpheli pozitif saptandı. 

Her iki olguya da   gastroduodenoskopi ve ince barsak biyopsisi yapıldı. 

Çalışma  grubundan alınan biopsi sonucu  çölyak hastalığı tespit 

edilirken , kontrol grubundan alınan biopsi sonucu normal duodenum 

mukozası olarak değerlendirildi.  

İki grup arasında istatiksel olarak anlamlı bir farklılık saptanmadı 

(p>0,05). 

Bu bulguların eşliğinde daha önce yapılan bir çalışmaya paralel 

olarak vitiligo hastalarında çölyak hastalığının sık görülmediğini 

saptadık. Vitiligo hastalarında çölyak hastalığı serolojik testlerinin rutin 

olarak kullanılmasının gerekli olmadığının kanaatine vardık. 

 

62

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