Michael Melanie
J Am Acad Nurse Pract. 2003 Mar;15(3):108-14. doi: 10.1111/j.1745-7599.2003.tb00266.x.
To heighten the awareness of primary care clinicians regarding the prevalence, clinical manifestations, diagnosis, and treatment of celiac disease (CD) in the primary care setting.
Selected research, clinical guidelines, research and clinically based articles from current scientific literature, and current medical textbooks.
Celiac disease is commonly under diagnosed or misdiagnosed. Until recently, it was considered rare in the United States. New data indicate that 1:150 Americans are affected and demonstrate the protective effects of early diagnosis and treatment.
Delays in the diagnosis and treatment of CD increase the risk of early mortality, associated autoimmune disease, neurologic complications, gastrointestinal malignancy, and fetal growth retardation, where pregnancy precedes diagnosis. Primary care clinicians must cultivate a high index of suspicion for CD in the primary care setting and bear it in mind as a differential diagnosis in many clinical situations.
提高基层医疗临床医生对基层医疗环境中乳糜泻（CD）的患病率、临床表现、诊断和治疗的认识。
从当前科学文献中选取的研究、临床指南、基于研究和临床的文章以及当前的医学教科书。
乳糜泻常被漏诊或误诊。直到最近，它在美国还被认为很罕见。新数据表明，每150名美国人中就有1人受其影响，并显示出早期诊断和治疗的保护作用。
乳糜泻诊断和治疗的延迟会增加早期死亡、相关自身免疫性疾病、神经系统并发症、胃肠道恶性肿瘤以及（在诊断前怀孕的情况下）胎儿生长受限的风险。基层医疗临床医生在基层医疗环境中必须对乳糜泻保持高度的怀疑指数，并在许多临床情况下将其作为鉴别诊断加以考虑。
