Mubarak A, Houwen R H J, Wolters V M
Departments of Pediatric Gastroenterology Utrecht University Medical Center, Utrecht, The Netherlands.
Minerva Pediatr. 2012 Jun;64(3):271-87.
Celiac disease (CD) is one of the most common immune-mediated diseases with a worldwide prevalence of around 1%, although a couple of decades ago the disease was thought to be very rare. CD is characterized by an inadequate inflammatory response to gluten in genetically susceptible individuals. In this inflammatory response both the adaptive and innate immunity are involved. The clinical picture of CD is variable ranging from severe malabsorption syndrome to silent cases. Disease specific antibodies can aid in selecting patients for a small intestinal biopsy, which is thought to be the gold standard investigation to diagnose CD. However, in selected patients, serology can be sufficient to confirm the diagnosis and a biopsy is not needed. Hitherto, the only treatment for CD is adherence to a lifelong strict gluten-free diet. The purpose of this review was to summarize current literature on the epidemiology and pathophysiology of CD and to discuss diagnostic and therapeutic approaches.
乳糜泻（CD）是最常见的免疫介导性疾病之一，全球患病率约为1%，尽管几十年前人们认为这种疾病非常罕见。CD的特征是在基因易感性个体中对麸质的炎症反应不足。在这种炎症反应中，适应性免疫和先天性免疫都参与其中。CD的临床表现多种多样，从严重的吸收不良综合征到无症状病例。疾病特异性抗体有助于选择进行小肠活检的患者，小肠活检被认为是诊断CD的金标准检查。然而，在特定患者中，血清学检查足以确诊，无需进行活检。迄今为止，CD的唯一治疗方法是坚持终身严格的无麸质饮食。本综述的目的是总结关于CD流行病学和病理生理学的当前文献，并讨论诊断和治疗方法。
