Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
Division of Pediatric Gastroenterology, Columbia University Medicine Center, 630 West 168th Street, PH-17, New York, NY 10032, USA.
Gastroenterol Clin North Am. 2019 Mar;48(1):19-37. doi: 10.1016/j.gtc.2018.09.001. Epub 2018 Dec 13.
The presentation in celiac disease is shifting from the classical malabsorptive presentation to more nonclassical presentations, requiring clinicians to maintain a high level of suspicion for the disease and to be aware of the possible extraintestinal manifestations. The diagnosis of celiac disease is guided by initial screening with serology, followed by confirmation with an upper endoscopy and small intestinal biopsy. In some pediatric cases, biopsy may be avoided.
在乳糜泻中，其表现正从经典的吸收不良表现转变为更多非经典表现，这要求临床医生对该疾病保持高度怀疑，并意识到可能存在的肠外表现。乳糜泻的诊断通过血清学进行初步筛查，然后通过上内窥镜检查和小肠活检进行确认。在一些儿科病例中，可能可以避免进行活检。
