Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania.
Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania.
World J Gastroenterol. 2022 Jun 28;28(24):2680-2688. doi: 10.3748/wjg.v28.i24.2680.
Celiac disease (CD) is well recognized as a systemic, chronic autoimmune disease mainly characterized by gluten-sensitive enteropathy in genetically predisposed individuals but with various extraintestinal features. One of the affected organs in CD is the pancreas, consisting of both endocrine and exocrine alterations. Over the last decades there has been increasing interest in the pancreatic changes in CD, and this has been reflected by a great number of publications looking at this extraintestinal involvement during the course of CD. While pancreatic endocrine changes in CD, focusing on type 1 diabetes mellitus, are well documented in the literature, the relationship with the exocrine pancreas has been less studied. This review summarizes currently available evidence with regard to pancreatic exocrine alterations in CD, focusing on risk of pancreatitis in CD patients, association with autoimmune pancreatitis, prevalence and outcomes of pancreatic exocrine insufficiency in newly diagnosed and gluten-free diet treated CD patients, and the link with cystic fibrosis. In addition, we discuss mechanisms behind the associated pancreatic exocrine impairment in CD and highlight the recommendations for clinical practice.
乳糜泻（CD）是一种被广泛认可的全身性、慢性自身免疫性疾病，主要表现为遗传易感性个体对麸质敏感的肠病，但也有各种肠外特征。CD 影响的器官之一是胰腺，其具有内分泌和外分泌改变。在过去几十年中，人们对 CD 中的胰腺变化越来越感兴趣，这反映在大量研究 CD 过程中这种肠外受累的出版物中。虽然 CD 中胰腺内分泌变化（主要为 1 型糖尿病）在文献中有充分记录，但与外分泌胰腺的关系研究较少。本文综述了目前关于 CD 中外分泌胰腺改变的相关证据，重点介绍了 CD 患者胰腺炎的风险、与自身免疫性胰腺炎的关联、新诊断和无麸质饮食治疗的 CD 患者中胰腺外分泌功能不全的患病率和结局，以及与囊性纤维化的关联。此外，我们还讨论了 CD 中相关胰腺外分泌损伤的机制，并强调了临床实践建议。
