MBBS, FRACP, PhD, Consultant Gastroenterologist and Laboratory Head, Immunology Division, The Walter and Eliza Hall Institute Parkville, and Gastroenterology Department, The Royal Melbourne Hospital, Parkville, Vic. @.
Aust J Gen Pract. 2018 Jan-Feb;47(1-2):28-33. doi: 10.31128/AFP-10-17-4357.
Coeliac disease is one of most prevalent autoimmune illnesses encountered in general practice, and general practitioners have a central role in its diagnosis and follow-up. Key challenges are improving its poor rate of detection, distinguishing it from 'gluten sensitivity', and monitoring and optimising treatment to enhance long‑term outcomes.
The objective of this article is to review the evidence-based use of serology, histology and genetic testing in the diagnosis and follow-up care of adults and children with coeliac disease.
Recognition and testing of at-risk patients are keys to expediting the diagnosis of coeliac disease. Knowing when and how to use serology, histology, human leukocyte antigen typing and gluten challenge will increase the accuracy of both diagnosis and disease monitoring.
在全科医学中，乳糜泻是最常见的自身免疫性疾病之一，全科医生在其诊断和随访中起着核心作用。主要挑战是提高其检出率，将其与“麸质敏感性”区分开来，并监测和优化治疗以改善长期预后。
本文旨在回顾在乳糜泻的诊断和随访中，基于循证的应用血清学、组织学和基因检测。
识别和检测高危患者是加速乳糜泻诊断的关键。了解何时以及如何使用血清学、组织学、人类白细胞抗原分型和麸质挑战将提高诊断和疾病监测的准确性。
