伪装成系统性红斑狼疮的麸质敏感性
Gluten sensitivity masquerading as systemic lupus erythematosus.
作者信息
Hadjivassiliou M, Sanders D S, Grünewald R A, Akil M
机构信息
Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
出版信息
Ann Rheum Dis. 2004 Nov;63(11):1501-3. doi: 10.1136/ard.2003.017947.
CASE REPORTS
Three patients are described whose original presentation and immunological profile led to the erroneous diagnosis of systemic lupus erythematosus. The correct diagnosis of gluten sensitivity was made after years of treatment with steroids and other immunosuppressive drugs.
CONCLUSIONS
The immunological profile of IgA deficiency and/or raised double stranded DNA in the absence of antinuclear factor together with raised inflammatory markers and symptoms suggestive of an immune diathesis should alert the physician to the possibility of gluten sensitivity. The presence of an enteropathy is no longer a prerequisite for the diagnosis of gluten sensitivity, which can solely present with extraintestinal symptoms and signs. Knowledge of the diverse manifestations of gluten sensitivity is essential in avoiding such misdiagnosis.
病例报告
描述了三名患者，他们最初的临床表现和免疫特征导致了系统性红斑狼疮的误诊。在使用类固醇和其他免疫抑制药物治疗多年后，才正确诊断为麸质敏感性。
结论
在无抗核因子的情况下，IgA缺乏和/或双链DNA升高的免疫特征，以及炎症标志物升高和提示免疫素质的症状，应提醒医生注意麸质敏感性的可能性。肠病不再是麸质敏感性诊断的先决条件，其可仅表现为肠外症状和体征。了解麸质敏感性的各种表现对于避免此类误诊至关重要。
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