Johnson Matthew W, Ellis H Julia, Asante Max A, Ciclitira Paul J
Royal Surrey Hospital, London, UK.
Nat Clin Pract Gastroenterol Hepatol. 2008 Dec;5(12):697-706. doi: 10.1038/ncpgasthep1281. Epub 2008 Oct 21.
Celiac disease is a common condition that is thought to affect 1 in 200 people throughout Europe and America, with prevalence rates reaching 1:100 in Ireland. Improvements in the sensitivity and specificity of serological testing for celiac disease over the past 15 years have resulted in a larger number of diagnoses being made. Up to 34% of patients with newly diagnosed celiac disease are older than 60 years of age. The symptomatic presentation of celiac disease in elderly patients can be subtle, leading to a considerable delay in diagnosis and potential accumulation of associated secondary complications. Given that celiac disease is associated with significant morbidity and reduced life expectancy, physicians need to be aware of this condition and its occurrence in the current increasingly elderly population. Compliance with a strict gluten-free diet is as easily achieved in elderly patients as in younger patients, and has been reported to reduce the risks of cancer and lymphoma associated with celiac disease. This Review highlights age-related differences in the clinical presentation and investigation of patients with suspected celiac disease.
乳糜泻是一种常见疾病,据认为在欧美地区每200人中就有1人受其影响,在爱尔兰患病率高达1:100。在过去15年里,乳糜泻血清学检测的敏感性和特异性有所提高,从而使更多病例得以确诊。新诊断出的乳糜泻患者中,高达34%的患者年龄超过60岁。老年患者乳糜泻的症状表现可能较为隐匿,导致诊断出现相当大的延迟,并可能累积相关的继发性并发症。鉴于乳糜泻与显著的发病率和预期寿命缩短相关,医生需要了解这种疾病及其在当前日益老龄化人口中的发生情况。老年患者与年轻患者一样容易严格遵守无麸质饮食,并且据报道,这可降低与乳糜泻相关的癌症和淋巴瘤风险。本综述重点介绍了疑似乳糜泻患者在临床表现和检查方面与年龄相关的差异。