Moscoso J Felipe, Quera P Rodrigo
Rev Med Chil. 2016 Feb;144(2):211-21. doi: 10.4067/S0034-98872016000200010.
The prevalence of Celiac disease in the general population is approximately 1% and remains undiagnosed in a significant proportion of individuals. Its clinical presentation includes the classical malabsorption syndrome, unspecific and extra-intestinal manifestations, and silent celiac disease. The serologic diagnosis has an elevated sensitivity and specificity and, at least in adult population, it must be confirmed by biopsy in every case. Diagnosis in subjects already on gluten free diet includes HLA typing and gluten challenge with posterior serologic and histologic evaluation. The core of the treatment is the gluten free diet, which must be supervised by an expert nutritionist. Monitoring must be performed with serology beginning at 3-6 months, and with histology two years after the diagnosis, unless the clinical response is poor. Poor disease control is associated with complications such as lymphoma and small bowel adenocarcinoma. In the future, it is likely that new pharmacologic therapies will be available for the management of celiac disease.
乳糜泻在普通人群中的患病率约为1%，且相当一部分患者仍未得到诊断。其临床表现包括典型的吸收不良综合征、非特异性和肠外表现以及隐匿性乳糜泻。血清学诊断具有较高的敏感性和特异性，至少在成人中，每种情况都必须通过活检来确诊。对已经采用无麸质饮食的患者进行诊断包括HLA分型以及随后进行血清学和组织学评估的麸质激发试验。治疗的核心是无麸质饮食，必须由专业营养师进行监督。监测应在3至6个月时开始进行血清学检查，诊断后两年进行组织学检查，除非临床反应不佳。疾病控制不佳与淋巴瘤和小肠腺癌等并发症相关。未来，可能会有新的药物疗法用于乳糜泻的管理。
