a ATS Lecco-Brianza , Limbiate (Monza Brianza) , Italy.
b University of Rome , Italy.
Expert Rev Gastroenterol Hepatol. 2019 Jun;13(6):541-546. doi: 10.1080/17474124.2019.1607295. Epub 2019 Apr 23.
Celiac disease (CD) is an immune-mediated disorder associated with gluten exposure in genetically predisposed subjects. Areas covered: Infectious disease is one of the causes of morbidity and mortality in CD patients. Invasive streptococcus pneumoniae (pneumococcus) is a particularly dangerous morbid condition in both the general population and celiac patients. Pneumococcal vaccination is the most effective means for its prevention. Expert opinion: In CD, evaluation of spleen function should be useful to select patients who may benefit from vaccination to reduce the risk of pneumococcal disease. Different strategies could be employed: physicians could search for signs of hyposplenism on peripheral blood smear or abdominal ultrasound. However, the best strategy to identify which patients will benefit from pneumococcal vaccination has not yet been defined.
乳糜泻（CD）是一种与遗传易感性个体接触麸质有关的免疫介导性疾病。
传染病是 CD 患者发病和死亡的原因之一。侵袭性肺炎链球菌（肺炎球菌）是普通人群和乳糜泻患者中一种特别危险的病态。肺炎球菌疫苗接种是预防它的最有效手段。
在 CD 中，评估脾脏功能可能有助于选择可能受益于疫苗接种以降低肺炎球菌病风险的患者。可以采用不同的策略：医生可以在外周血涂片或腹部超声上寻找脾功能低下的迹象。然而，尚未确定确定哪些患者将从肺炎球菌疫苗接种中受益的最佳策略。
