Meijer Caroline R, Shamir Raanan, Mearin Maria L
*Department of Paediatric Gastroenterology, Leiden University Medical Center, Leiden, The Netherlands †Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Petach-Tikva, Israel.
J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):429-32. doi: 10.1097/MPG.0000000000000708.
The spectrum of gluten-related disorders was restricted to coeliac disease and wheat allergy, but the new contemporary entity referred to as noncoeliac gluten sensitivity has gained recognition mainly in adults but also in children. Noncoeliac gluten sensitivity is defined as the presence of a variety of symptoms related to gluten ingestion in patients in whom coeliac disease and wheat allergy have been excluded. The pathophysiology and biomarkers of coeliac disease and wheat allergy are well known, but this is not the case for noncoeliac gluten sensitivity. It is also not clear whether noncoeliac gluten sensitivity is caused by consumption of gluten or by consumption of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Randomized trials on noncoeliac gluten sensitivity in children are lacking and are hardly needed to evaluate its role in paediatric patients with gastroenterology to avoid the use of unnecessary restrictive diets in children and interference with proper diagnosis of coeliac disease.
麸质相关疾病的范围曾局限于乳糜泻和小麦过敏，但新出现的被称为非乳糜泻麸质敏感的当代病症已得到认可，主要见于成人，但儿童中也有。非乳糜泻麸质敏感被定义为在已排除乳糜泻和小麦过敏的患者中，存在与摄入麸质相关的多种症状。乳糜泻和小麦过敏 的病理生理学及生物标志物已为人熟知，但非乳糜泻麸质敏感并非如此。非乳糜泻麸质敏感是由麸质摄入引起还是由可发酵寡糖、双糖、单糖和多元醇的摄入引起也尚不清楚。儿童非乳糜泻麸质敏感的随机试验缺乏，而且对评估其在儿科胃肠病患者中的作用而言几乎没有必要，这样可以避免儿童采用不必要的限制性饮食以及干扰乳糜泻的正确诊断。
