Malamut Georgia, Cellier Christophe
Service d'hépatogastroentérologie, Hôpital européen Georges-Pompidou, Université Paris-Descartes, 75908 Paris 15, France.
Rev Prat. 2008 Jun 15;58(11):1199-205.
Celiac disease is an enteropathy due to gluten intake in genetically predisposed persons (HLA DQ2/DQ8). Celiac disease occurs in adults and children at rates approaching 1% of population in Europe and USA. Clinical presentation of celiac disease is extremely varied. Anaemia, oral aphthous stomatis, amenorrhea or articular symptoms may reveal celiac disease. Diagnosis relies on evidence of duodenal villous atrophy and specific serum antibodies. Treatment relies on eviction of gluten (wheat, barley, rye). Gluten-free diet allows prevention of malignant complications and osteopenia. The main cause of resistance to gluten-free diet is its bad observance. On the contrary, serious complications of celiac disease, such as clonal refractory celiac sprue and intestinal T cell lymphoma need to be screen.
乳糜泻是一种在具有遗传易感性(HLA DQ2/DQ8)的人群中因摄入麸质而引发的肠病。在欧洲和美国,成人和儿童乳糜泻的发病率接近总人口的1%。乳糜泻的临床表现极为多样。贫血、口腔阿弗他口炎、闭经或关节症状都可能提示乳糜泻。诊断依赖于十二指肠绒毛萎缩的证据和特定的血清抗体。治疗依赖于去除麸质(小麦、大麦、黑麦)。无麸质饮食可预防恶性并发症和骨质减少。对无麸质饮食产生抵抗的主要原因是对其依从性差。相反,需要筛查乳糜泻的严重并发症,如克隆性难治性乳糜泻和肠T细胞淋巴瘤。