麸质、泼尼松和硫唑嘌呤在难治性乳糜泻中的作用。

Role of gluten, prednisone, and azathioprine in non-responsive coeliac disease.

作者信息

Hamilton J D, Chambers R A, Wynn-Williams A

出版信息

Lancet. 1976 Jun 5;1(7971):1213-6. doi: 10.1016/s0140-6736(76)92162-0.

Abstract

A case of severe "non-responsive" coeliac disease has been shown to be sensitive to gluten whilst under prednisone therapy, but not without prednisone. This adds an additional dimension to the criteria for diagnosis of coeliac disease. Cases of non-responsive coeliac disease may require both prednisone and gluten exclusion to induce a remission. In this patient, azathioprine induced and sustained a remission when unacceptably high doses of prednisone had failed, and may prove to be a valuable immunosuppressive in non-responsive coeliac disease.

摘要

一例严重的“难治性”乳糜泻患者在泼尼松治疗期间对麸质敏感，但停用泼尼松则不然。这为乳糜泻的诊断标准增添了新的维度。难治性乳糜泻病例可能需要泼尼松和排除麸质共同作用才能诱导缓解。在该患者中，当高得难以接受的泼尼松剂量治疗失败时，硫唑嘌呤诱导并维持了缓解，且可能被证明是难治性乳糜泻中一种有价值的免疫抑制剂。