Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, WA 6001, Australia.
Expert Rev Gastroenterol Hepatol. 2013 Sep;7(7):643-55. doi: 10.1586/17474124.2013.834125.
Celiac disease (CD) is an immune-mediated systemic condition triggered by dietary gluten occurring in genetically susceptible individuals. Our understanding of its numerous and varied clinical presentations has evolved over time, which has contributed to the incidence of CD increasing. In most cases, the diagnosis is readily established and patients promptly improve after commencing a gluten-free diet (GFD). However, in some, the diagnosis is not straightforward and presents a challenge to clinicians. Potential dilemmas include those with positive serology but normal histology, negative serology but abnormal duodenal mucosal histology, failure to respond to a GFD or response to a GFD without evidence of CD. In recent years, development of new assays and modifications to existing diagnostic algorithms for CD has also challenged the traditional role of small-bowel histology as critical in CD diagnosis.
乳糜泻（CD）是一种由遗传易感个体摄入膳食麸质引发的免疫介导的全身性疾病。随着时间的推移，我们对其众多不同临床表现的认识不断发展，这导致 CD 的发病率增加。在大多数情况下，诊断很容易确立，患者在开始无麸质饮食（GFD）后会迅速改善。然而，在某些情况下，诊断并不简单，这对临床医生来说是一个挑战。潜在的困境包括那些血清学阳性但组织学正常、血清学阴性但十二指肠黏膜组织学异常、对 GFD 无反应或对 GFD 有反应但无 CD 证据的患者。近年来，CD 的新检测方法的发展和对现有诊断算法的修改也对小肠组织学在 CD 诊断中的关键作用提出了挑战。
