Dore Maria Pina, Cuccu Marianna, Pes Gianni Mario, Mameli Laura, Manca Allesandra, Vidili Gian Paolo, Togniotti Eugenia
Dipartimento di Medicina Clinica e Sperimentale, Universita di Sassari.
Recenti Prog Med. 2012 Dec;103(12):564-9. doi: 10.1701/1206.13357.
Celiac disease (CD) was first described by Aretaeus from Cappadocia in II century after C. The impressive clinical picture of a patient with life-threatening diarrhea, malabsorption, weight loss, neurologic disorders and osteopenia is now often replaced by the mostly atypical symptoms or an asymptomatic presentation. When unrecognized and untreated, the celiac disease is associated with increased mortality. In order to collect information on the clinical presentation of celiac disease in North Sardinia, Italy, data on 287 patients with biopsy examination-proven celiac disease were obtained. Women predominated (87%). Overall 78,2%, 53,2% and 44,7% of patients showed classical, subclinical/silent or atypical, and no gastrointestinal features of celiac disease, respectively. Anemia was the main mode of presentation, occurring in 53% of patients. Diarrhea was less frequent (41,5%), although never severe. In conclusion, in North Sardinia a significant proportion of patients with CD are seen more commonly with non-diarrheal presentations than those with diarrhea. To recognize atypical symptoms could be the most important step in the diagnosis and further treatment.
乳糜泻(CD)最早由公元2世纪来自卡帕多西亚的阿雷泰乌斯描述。如今,患有危及生命的腹泻、吸收不良、体重减轻、神经紊乱和骨质减少的患者那令人印象深刻的临床表现,常常被大多不典型的症状或无症状表现所取代。如果未被识别和治疗,乳糜泻会导致死亡率上升。为了收集意大利撒丁岛北部乳糜泻临床表现的信息,我们获取了287例经活检检查证实为乳糜泻患者的数据。女性占多数(87%)。总体而言,分别有78.2%、53.2%和44.7%的患者表现出乳糜泻的典型、亚临床/无症状或非典型症状,且无胃肠道特征。贫血是主要的表现形式,53%的患者出现贫血。腹泻较少见(41.5%),尽管从未严重过。总之,在撒丁岛北部,与腹泻型患者相比,相当一部分乳糜泻患者更常见的是非腹泻型表现。识别非典型症状可能是诊断和进一步治疗的最重要步骤。