Celiac disease: a review.
Celiac disease: a review.
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DOI：
10.1001/jamapediatrics.2013.3858
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发表时间：
2014-03-01
期刊：
影响因子：
26.1
通讯作者：
Assiri, Asaad
中科院分区：
文献类型：
--
作者：
Guandalini, Stefano;Assiri, Asaad
由遗传易感个体摄入麸质引发的乳糜泻是世界上最常见的遗传性食物不耐受，约占总人口的1%。这种肠病可能出现在任何年龄，其特征是各种各样的临床体征和症状，远远超出了胃肠道。在幼儿中，胃肠道表现很常见，包括慢性腹泻、发育不良和腹胀;然而，肠外表现越来越常见。它们包括许多疾病，如疱疹样皮炎、贫血、牙釉质发育不全、复发性口腔口疮、身材矮小、骨质疏松、关节炎、神经系统问题、原因不明的转氨酶水平升高和女性不孕症。因此，诊断乳糜泻需要高度怀疑，然后进行正确的筛查和肠道活检的确证性试验。诊断后，必须遵循严格的无麸质饮食，这在大多数情况下会带来症状的显着改善。然而，存在重要的依从性和生活质量问题，特别是在青少年中。
Triggered by the ingestion of gluten in genetically predisposed individuals, celiac disease is the most common genetically based food intolerance in the world, with a prevalence among approximately 1% of the general population. This enteropathy may appear at any age and is characterized by a wide variety of clinical signs and symptoms that go well beyond the gastrointestinal tract. In young children, gastrointestinal presentations are common and include chronic diarrhea, failure to thrive, and abdominal distention; however, extraintestinal manifestations are becoming increasingly more common. They include numerous conditions such as dermatitis herpetiformis, anemia, dental enamel hypoplasia, recurrent oral aphthae, short stature, osteoporosis, arthritis, neurologic problems, unexplained elevation of transaminase levels, and female infertility. Therefore, diagnosing celiac disease requires a high degree of suspicion, followed by correct screening and a confirmatory test with an intestinal biopsy. After diagnosis, a strict gluten-free diet must be followed, which in most cases will bring a marked improvement of symptoms. However, there are important compliance and quality-of-life problems, especially in adolescents.