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探索十字路口:剖析乳糜泻与布加综合征的交集——见解、挑战及管理策略

Navigating the crossroads: exploring the intersection of celiac disease and Budd-Chiari syndrome - insights, challenges, and management strategies.

作者信息

Lal Priyanka Mohan, Madhumal Heema, Siddiqui Muhammad Hamza, Parvez Syed Shahrukh, Parvez Syed Shahzil, Husain Mustafa Ashiq, Tirath Komal, Mohan Anmol, Tanush Dev, Duseja Nikhil, Khan Muhammad Khuzzaim, Sherazi Syeda Laiba, Tejwaney Usha

机构信息

Ziauddin Medical University, Karachi, Pakistan.

Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Ann Med Surg (Lond). 2025 Apr 22;87(6):3610-3617. doi: 10.1097/MS9.0000000000003320. eCollection 2025 Jun.

DOI:10.1097/MS9.0000000000003320
PMID:40486601
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12140794/
Abstract

Celiac disease (CD) and Budd-Chiari syndrome (BCS) are distinct medical conditions affecting different organ systems. However, reports suggest a potential association between them. This review examines existing literature and summarizes the current knowledge regarding the connection between CD and BCS. The pathophysiology of both conditions involves immune dysregulation and prothrombotic tendencies, though through different mechanisms. Several case reports and small studies indicate an increased incidence of BCS in individuals with CD, but the underlying mechanisms remain unclear. Proposed hypotheses include chronic inflammation, hypercoagulability, and potential genetic factors. However, more robust studies are needed to establish a definitive association and elucidate the shared pathophysiological factors between the two conditions. Management of CD primarily involves strict adherence to a gluten-free diet, leading to symptom improvement and normalization of serological markers. BCS requires a stepwise approach involving anticoagulation, endovascular therapy, and, in severe cases, liver transplantation. Recognizing the potential implications of the coexistence of CD and BCS is crucial for developing appropriate management strategies. Further research is warranted to investigate the potential association between CD and BCS, including large-scale epidemiological studies, genetic analyses, and mechanistic investigations. Understanding the underlying mechanisms and identifying risk factors for BCS development in individuals with CD will contribute to enhanced diagnostic capabilities, refined management strategies, and improved patient outcomes.

摘要

乳糜泻(CD)和布加综合征(BCS)是影响不同器官系统的不同疾病。然而,有报告表明它们之间可能存在关联。本综述审视了现有文献,并总结了关于CD与BCS之间联系的当前知识。这两种疾病的病理生理学都涉及免疫失调和血栓形成倾向,尽管机制不同。一些病例报告和小型研究表明,CD患者中BCS的发病率有所增加,但其潜在机制仍不清楚。提出的假说是慢性炎症、高凝状态和潜在的遗传因素。然而,需要更有力的研究来确定两者之间的明确关联,并阐明这两种疾病共有的病理生理因素。CD的治疗主要包括严格遵循无麸质饮食,从而改善症状并使血清学指标恢复正常。BCS需要采取逐步的治疗方法,包括抗凝、血管内治疗,严重时还需要进行肝移植。认识到CD和BCS共存的潜在影响对于制定适当的管理策略至关重要。有必要进行进一步研究,以调查CD与BCS之间的潜在关联,包括大规模流行病学研究、基因分析和机制研究。了解潜在机制并确定CD患者发生BCS的危险因素,将有助于提高诊断能力、完善管理策略并改善患者预后。

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Ann Med Surg (Lond). 2025 Apr 22;87(6):3610-3617. doi: 10.1097/MS9.0000000000003320. eCollection 2025 Jun.
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本文引用的文献

1
From Sugar Spikes to Pressure Peaks: Navigating the World of Diabetes, Hypertension, Obesity, and Kidney Health.从血糖飙升到血压峰值:探索糖尿病、高血压、肥胖症与肾脏健康的世界。
Cureus. 2024 Mar 30;16(3):e57241. doi: 10.7759/cureus.57241. eCollection 2024 Mar.
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Budd-Chiari syndrome in children: Challenges and outcome.儿童布加综合征:挑战与预后
World J Hepatol. 2023 Nov 27;15(11):1174-1187. doi: 10.4254/wjh.v15.i11.1174.
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Histopathology of Budd-Chiari Syndrome.布加综合征的组织病理学
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Nutritional status, nutrient imbalances, food-related behaviors and dietary supplements use among patients with celiac disease on a gluten free diet in Lebanon: a national cross-sectional study.黎巴嫩无麸质饮食下乳糜泻患者的营养状况、营养失衡、与食物相关的行为和膳食补充剂使用情况:一项全国性横断面研究。
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Osteoporosis and Celiac Disease: Updates and Hidden Pitfalls.骨质疏松症与乳糜泻:最新进展与潜在误区。
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Celiac Disease and Gallbladder: Pathophysiological Aspects and Clinical Issues.乳糜泻与胆囊:病理生理方面和临床问题。
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"Long-term follow-up and prognosis of celiac hepatitis"."乳糜泻性肝炎的长期随访和预后"。
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Coeliac disease.乳糜泻
Lancet. 2022 Jun 25;399(10344):2413-2426. doi: 10.1016/S0140-6736(22)00794-2. Epub 2022 Jun 9.
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Celiac Disease and Thrombotic Events: Systematic Review of Published Cases.乳糜泻与血栓事件:已发表病例的系统综述。
Nutrients. 2022 May 23;14(10):2162. doi: 10.3390/nu14102162.
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State of the Art, Current Perspectives, and Controversies of Budd-Chiari Syndrome: A Review.布加综合征的现状、当前观点及争议:综述
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