"Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Gastroenterology Department, "Dr. Carol Davila" Central Military Emergency University Hospital, 010825 Bucharest, Romania.
Medicina (Kaunas). 2019 Jul 15;55(7):373. doi: 10.3390/medicina55070373.
Celiac disease (CD) is a systemic autoimmune disease driven by gluten-ingestion in genetically predisposed individuals. Although it primarily affects the small bowel, CD can also involve other organs and manifest as an extraintestinal disease. Among the extraintestinal features of CD, hematologic ones are rather frequent and consist of anemia, thrombocytosis (thrombocytopenia also, but rare), thrombotic or hemorrhagic events, IgA deficiency, hyposplenism, and lymphoma. These hematologic alterations can be the sole manifestation of the disease and should prompt for CD testing in a suggestive clinical scenario. Recognition of these atypical, extraintestinal presentations, including hematologic ones, could represent a great opportunity to increase the diagnostic rate of CD, which is currently one of the most underdiagnosed chronic digestive disorders worldwide. In this review, we summarize recent evidence regarding the hematological manifestations of CD, with focus on practical recommendations for clinicians.
乳糜泻（CD）是一种由遗传易感性个体摄入麸质引起的系统性自身免疫性疾病。虽然它主要影响小肠，但 CD 也可能涉及其他器官并表现为肠外疾病。在 CD 的肠外特征中，血液学特征相当常见，包括贫血、血小板增多症（也有血小板减少症，但罕见）、血栓形成或出血事件、IgA 缺乏症、脾功能减退症和淋巴瘤。这些血液学改变可能是该疾病的唯一表现，并且在提示性临床情况下应促使进行 CD 检测。认识到这些非典型的、肠外表现，包括血液学表现，可能是提高 CD 诊断率的绝佳机会，目前 CD 是全球最被低估的慢性消化系统疾病之一。在这篇综述中，我们总结了有关 CD 血液学表现的最新证据，重点是为临床医生提供实用建议。
