成人绒毛萎缩性肠病但乳糜泻血清学阴性：当前问题。
Enteropathies with villous atrophy but negative coeliac serology in adults: current issues.
机构信息
Gastroenterology Unit of Pavia Institute, Maugeri Clinical Research Institutes IRCCS, University of Pavia, Pavia, Italy.
Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, United Kigdom
出版信息
BMJ Open Gastroenterol. 2021 Nov;8(1). doi: 10.1136/bmjgast-2021-000630.
OBJECTIVE
The differential diagnosis and management of seronegative enteropathies is challenging due to the rarity of these conditions, the overlap of clinical and histopathological features and the current lack of an international consensus on their nomenclature.
DESIGN
This is a narrative review providing pragmatic guide on the investigation and clinical management of seronegative enteropathies in adults based on the available literature and our clinical experience.
CONCLUSIONS
Seronegative coeliac disease is the most frequent cause among the heterogeneous group of seronegative enteropathies and its diagnosis is confirmed by the clinical and histological response to a gluten-free diet after the exclusion of other causes of villous atrophy. Correct identification and targeted management of seronegative enteropathies is mandatory because of the variation in terms of clinical outcomes and prognosis.
目的
由于这些疾病较为罕见，且临床表现和组织病理学特征存在重叠，同时目前在命名方面也尚未达成国际共识，因此，血清阴性肠病的鉴别诊断和处理具有一定挑战性。
设计
本研究为叙述性综述，基于现有文献和我们的临床经验，为成人血清阴性肠病的检查和临床管理提供实用指南。
结论
血清阴性乳糜泻是血清阴性肠病这一类异质性疾病中最常见的病因，在排除其他绒毛萎缩病因后，通过无麸质饮食可使临床和组织学得到缓解，从而明确诊断。正确识别和针对性管理血清阴性肠病非常重要，因为其临床转归和预后存在差异。
Zotero 插件