Iwańczak Franciszek, Iwańczak Barbara
Uniwersytet Medyczny im. Piastów Slaskich we Wrocławiu, II Katedra i Klinika Pediatrii, Gastroenterologii i Zywienia.
Pol Merkur Lekarski. 2013 Jul;35(205):47-50.
Refractory celiac disease is characterized by the persistence or recurrence of symptoms connected with enteropathy, presence of specific antibodies in the serum: EMA, tTG2 and DPG, and (or) intestinal villous atrophy despite strict adherence to gluten-free diet for 6 to 12 months. Correct initial diagnosis of celiac disease, exclusion of other causes of the lack of response to gluten-free diet and persistence of villous atrophy are necessary conditions of diagnosis of refractory celiac disease. Options of the treatment, depending on the patient condition are: gluten-free diet, elementary diet, parenteral nutrition, immunosuppression and biological therapy.
难治性乳糜泻的特征是与肠病相关的症状持续或复发、血清中存在特异性抗体：肌内膜抗体（EMA）、组织转谷氨酰胺酶2（tTG2）和脱酰胺麦醇溶蛋白-谷蛋白抗体（DPG），以及尽管严格坚持无麸质饮食6至12个月仍存在肠绒毛萎缩。正确初步诊断乳糜泻、排除对无麸质饮食无反应及绒毛萎缩持续存在的其他原因是诊断难治性乳糜泻的必要条件。治疗方案根据患者情况包括：无麸质饮食、要素饮食、肠外营养、免疫抑制和生物治疗。
