Celiac Disease in the Elderly.
Celiac Disease in the Elderly.
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DOI：
10.1007/s11938-022-00397-8
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发表时间：
2022-09
期刊：
影响因子：
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通讯作者：
Lebwohl, Benjamin
中科院分区：
文献类型：
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作者：
Ching, Charlotte K;Lebwohl, Benjamin
这篇综述强调了过去几年的文献，并探讨了对当前对老年人乳糜泻诊断、并发症和治疗的理解的影响。老年乳糜泻正变得越来越普遍，但仍未得到充分诊断，具有潜在的下游发病率负担和适度增加的死亡风险。临床表现通常与肠外症状有关，并且可能很微妙。十二指肠活检仍然是老年人诊断的金标准，以及支持血清学。难治性乳糜泻是老年人特别关注的问题，对这种罕见疾病的治疗仍不令人满意。老年人表现出较低的粘膜愈合率，尽管其原因尚不清楚。目前对老年人乳糜泻的了解在继续推进，尽管存在显著的知识差距。需要大规模的前瞻性研究来进一步描述老年人乳糜泻的发病机制、并发症和治疗。
This review highlights literature from the past several years and explores the impact on current understanding of celiac disease diagnosis, complications, and management in older adults. Celiac disease in the elderly is becoming increasingly prevalent but remains underdiagnosed, with a high potential burden of downstream morbidity and modestly increased risk of mortality. Clinical presentations are often related to extraintestinal symptoms and can be subtle. Duodenal biopsy remains the gold-standard for diagnosis in older adults, along with supporting serologies. Refractory celiac disease is a particular concern in the aging population, and treatment for this rare condition remains unsatisfactory. Older adults exhibit lower rates of mucosal healing, though the reasons for this are poorly understood. Current understanding of celiac disease in the elderly continues to advance, though significant knowledge gaps persist. Large, prospective studies are needed to further characterize celiac disease pathogenesis, complications, and management in older adults.