Rostami Kamran, Aldulaimi David, Holmes Geoffrey, Johnson Matt W, Robert Marie, Srivastava Amitabh, Fléjou Jean-François, Sanders David S, Volta Umberto, Derakhshan Mohammad H, Going James J, Becheanu Gabriel, Catassi Carlo, Danciu Mihai, Materacki Luke, Ghafarzadegan Kamran, Ishaq Sauid, Rostami-Nejad Mohammad, Peña A Salvador, Bassotti Gabrio, Marsh Michael N, Villanacci Vincenzo
Kamran Rostami, David Aldulaimi, Luke Materacki, Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, United Kingdom.
World J Gastroenterol. 2015 Mar 7;21(9):2593-604. doi: 10.3748/wjg.v21.i9.2593.
Microscopic enteritis (ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms, nutrient and micronutrient deficiency. It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy. This work recognises a need to characterize disorders with microscopic and submicroscopic features, currently regarded as functional or non-specific entities, to obtain further understanding of their clinical relevance. The consensus working party reviewed statements about the aetiology, diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment. Following the 5(th) International Course in Digestive Pathology in Bucharest in November 2012, an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME. A five-step agreement scale (from strong agreement to strong disagreement) was used to score 21 statements, independently. There was strong agreement on all statements about ME histology (95%-100%). Statements concerning diagnosis achieved 85% to 100% agreement. A statement on the management of ME elicited agreement from the lowest rate (60%) up to 100%. The remaining two categories showed general agreement between experts on clinical presentation (75%-95%) and pathogenesis (80%-90%) of ME. There was strong agreement on the histological definition of ME. Weaker agreement on management indicates a need for further investigations, better definitions and clinical trials to produce quality guidelines for management. This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.
显微镜下肠炎(ME)是一种小肠炎症性疾病,可导致胃肠道症状、营养物质和微量营养素缺乏。其特征是在使用标准现代内窥镜检查时,不存在明确的宏观变化,但存在微观或亚微观异常,如微绒毛改变和肠细胞改变。这项工作认识到需要对具有微观和亚微观特征的疾病进行特征描述,这些疾病目前被视为功能性或非特异性实体,以便进一步了解它们的临床相关性。共识工作小组审查了有关ME的病因、诊断和症状的陈述,并提出了其调查和治疗的算法。在2012年11月于布加勒斯特举行的第五届国际消化病理学课程之后,由21名感兴趣的病理学家和胃肠病学家组成的国际小组成立了一个工作小组,旨在就ME制定一份共识声明。使用一个五步同意量表(从强烈同意到强烈不同意)对21项陈述进行独立评分。关于ME组织学的所有陈述都达成了强烈共识(95%-100%)。关于诊断的陈述达成了85%至100%的共识。一项关于ME管理的陈述获得的同意率从最低的60%到100%不等。其余两类在ME的临床表现(75%-95%)和发病机制(80%-90%)方面,专家们普遍达成了共识。对ME的组织学定义达成了强烈共识。在管理方面较弱的共识表明需要进一步研究、更好的定义和临床试验,以制定高质量的管理指南。这份ME共识是朝着更广泛地认识一种重要疾病迈出的一步,这种疾病影响着以前被标记为非特异性或功能性肠病的有症状患者。
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