Casella Giovanni, Viganò Davide, Romano Settanni Carlo, Morelli Olivia, Villanacci Vincenzo, Baldini Vittorio, Bassotti Gabrio
Medical Department, Desio Hospital, Desio (Monza e Brianza), Italy.
Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy.
Gastroenterol Hepatol Bed Bench. 2016 Summer;9(3):153-7.
Celiac disease is characterized by a gluten-induced damage of the small bowel in sensitive individuals that may cause malabsorption. Non-intestinal inflammatory diseases may trigger immunologic gluten intolerance in susceptible people and the HCV virus may be considered as a suitable candidate. Interferon therapy could precipitate symptom onset in subjects with silent celiac disease. In fact, symptoms such as diarrhea, anemia, and weight loss may occur during interferon therapy and are associated with serological positivity of anti-tranglutaminase antibodies. To date, considering the available literature data, it is very difficult to support a firm association between HCV chronic hepatitis and celiac disease. Thus, such a serological screening in HCV patients before starting interferon therapy should not be recommended. However, serology for celiac disease must be considered in patients who develop diarrhea and/or weight loss during such therapy.
乳糜泻的特征是在敏感个体中由麸质引起的小肠损伤,这可能导致吸收不良。非肠道炎性疾病可能在易感人群中引发免疫性麸质不耐受,丙型肝炎病毒(HCV)可能是一个合适的候选因素。干扰素治疗可能会使无症状乳糜泻患者出现症状。事实上,腹泻、贫血和体重减轻等症状可能在干扰素治疗期间出现,并与抗转谷氨酰胺酶抗体的血清学阳性有关。迄今为止,根据现有文献数据,很难支持HCV慢性肝炎与乳糜泻之间存在确凿关联。因此,不建议在开始干扰素治疗前对HCV患者进行此类血清学筛查。然而,对于在这种治疗期间出现腹泻和/或体重减轻的患者,必须考虑进行乳糜泻血清学检查。