Chapoy P, Elbaz F, Bernard R, Louchet E
Nouv Presse Med. 1981 Feb 7;10(5):325-7.
Between 1969 and 1979, 123 cases of gluten-induced enteropathy were diagnosed in south-eastern France. The overall incidence of the disease was estimated at approximately one for 4 600 births. The mean age of the patients was 3.2 years. At the time of diagnosis, 71 children (57,7%) were less than 2 years old, and 52 children (42,3%) were above that age. There was a strong predominance of girls (60%) and North-Africans (48%). Children younger than 2 years presented with the usual malabsorption syndrome, whereas growth retardation, often isolated, was the main feature in older children. The relative increase observed since 1976 in the number of patients of the latter group despite a lower incidence of the disease was probably due to the withdrawal of infants' foods containing gluten. In 58 children followed up dietetic measures resulted in rapid clinical improvement, but healing of the mucosal lesions was much slower (19 months on average). In 28 patients who could be followed for longer periods, reintroducing gluten into the diet regularly led to histological relapse. These patients, however, had been selected for particular reasons. The true incidence of transient intolerance to gliadin is difficult to determine, since most subjects in perfect health refuse control biopsies.
1969年至1979年间,法国东南部诊断出123例麸质诱发的小肠病。该病的总体发病率估计约为每4600例出生中有1例。患者的平均年龄为3.2岁。诊断时,71名儿童(57.7%)年龄小于2岁,52名儿童(42.3%)年龄大于2岁。女孩(60%)和北非人(48%)占比很高。2岁以下的儿童表现出常见的吸收不良综合征,而生长发育迟缓(通常较为孤立)是大龄儿童的主要特征。尽管发病率较低,但自1976年以来后一组患者数量相对增加,这可能是由于含麸质婴儿食品的停用。在58名接受饮食措施随访的儿童中,临床症状迅速改善,但黏膜病变的愈合要慢得多(平均19个月)。在28名能够随访更长时间的患者中,饮食中定期重新引入麸质通常会导致组织学复发。然而,这些患者是因特殊原因被挑选出来的。由于大多数健康状况良好的受试者拒绝进行对照活检,因此难以确定对麦醇溶蛋白短暂不耐受的真实发病率。