Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, United Kingdom.
J Gastrointestin Liver Dis. 2020 Mar 13;29(1):111-113. doi: 10.15403/jgld-718.
Coeliac disease affects 1% of the population but internationally delays in diagnosis are frequent. A relationship between irritable bowel syndrome type symptoms and coeliac disease is well established and most IBS guidelines recommend that patients presenting with IBS type symptoms should be tested serologically for coeliac disease. Seronegative coeliac disease accounts for 3-5% of all cases of coeliac disease and it is a diagnostic challenge which requires a high level of clinical suspicion and consideration of duodenal biopsies prior to confidently excluding this diagnosis. We report the first case of seronegative coeliac disease masquerading as IBS type symptoms. We suggest that if patients have evidence of haematinic deficiency, subsequent weight loss, features of malabsorption or a family history of coeliac disease, then a duodenal biopsy should be considered irrespective of negative serology.
乳糜泻影响人口的 1%，但国际上诊断延迟很常见。肠易激综合征型症状与乳糜泻之间存在明确的关系，大多数肠易激综合征指南建议，出现肠易激综合征型症状的患者应进行乳糜泻血清学检查。血清阴性乳糜泻占乳糜泻所有病例的 3-5%，这是一个诊断挑战，需要高度的临床怀疑，并在有信心排除该诊断之前考虑十二指肠活检。我们报告首例表现为肠易激综合征型症状的血清阴性乳糜泻。我们建议，如果患者有血液学缺乏的证据、随后的体重减轻、吸收不良的特征或乳糜泻家族史，那么无论血清学检查是否为阴性，都应考虑进行十二指肠活检。
