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儿童乳糜泻:文献综述

Celiac disease in children: A review of the literature.

作者信息

Sahin Yasin

机构信息

Pediatric Gastroenterology-Hepatology and Nutrition, Medical Park Gaziantep Hospital, Gaziantep 27560, Turkey.

出版信息

World J Clin Pediatr. 2021 Jul 9;10(4):53-71. doi: 10.5409/wjcp.v10.i4.53.

Abstract

Celiac disease is an immune-mediated systemic disease triggered by intake of gluten in genetically susceptible individuals. The prevalence of celiac disease in the general population is estimated to be 1% in the world. Its prevalence differs depending on geographical and ethnic variations. The prevalence of celiac disease has increased significantly in the last 30 years due to the increased knowledge and awareness of physicians and the widespread use of highly sensitive and specific diagnostic tests for celiac disease. Despite increased awareness and knowledge about celiac disease, up to 95% of celiac patients still remain undiagnosed. The presentations of celiac disease have significantly changed in the last few decades. Classical symptoms of celiac disease occur in a minority of celiac patients, while older children have either minimal or atypical symptoms. Serologic tests for celiac disease should be done in patients with unexplained chronic or intermittent diarrhea, failure to thrive, weight loss, delayed puberty, short stature, amenorrhea, iron deficiency anemia, nausea, vomiting, chronic abdominal pain, abdominal distension, chronic constipation, recurrent aphthous stomatitis, and abnormal liver enzyme elevation, and in children who belong to specific groups at risk. Early diagnosis of celiac disease is very important to prevent long-term complications. Currently, the only effective treatment is a lifelong gluten-free diet. In this review, we will discuss the epidemiology, clinical findings, diagnostic tests, and treatment of celiac disease in the light of the latest literature.

摘要

乳糜泻是一种由麸质摄入引发的免疫介导性全身性疾病,好发于具有遗传易感性的个体。据估计,全球普通人群中乳糜泻的患病率为1%。其患病率因地域和种族差异而有所不同。在过去30年中,由于医生对该病的认识和了解增加,以及高灵敏度和特异性的乳糜泻诊断检测方法的广泛应用,乳糜泻的患病率显著上升。尽管对乳糜泻的认识和了解有所增加,但仍有高达95%的乳糜泻患者未被诊断出来。在过去几十年中,乳糜泻的临床表现发生了显著变化。典型的乳糜泻症状仅出现在少数患者中,而大龄儿童的症状要么很轻微,要么不典型。对于患有不明原因的慢性或间歇性腹泻、生长发育迟缓、体重减轻、青春期延迟、身材矮小、闭经、缺铁性贫血、恶心、呕吐、慢性腹痛、腹胀、慢性便秘、复发性阿弗他口炎以及肝酶异常升高的患者,以及属于特定高危人群的儿童,都应进行乳糜泻的血清学检测。乳糜泻的早期诊断对于预防长期并发症非常重要。目前,唯一有效的治疗方法是终身无麸质饮食。在这篇综述中,我们将根据最新文献讨论乳糜泻的流行病学、临床表现、诊断检测和治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2878/8290992/267cd6fae691/WJCP-10-53-g001.jpg

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