Pruessner H T
University of Texas Medical School at Houston, USA.
Am Fam Physician. 1998 Mar 1;57(5):1023-34, 1039-41.
Celiac disease is a genetic, immunologically mediated small bowel enteropathy that causes malabsorption. The immune inflammatory response to gluten frequently causes damage to many other tissues of the body. The condition is frequently underdiagnosed because of its protean presentations. New prevalence data indicate that symptomatic and latent celiac disease is present in one of 300 people of European descent. Age of onset ranges from infancy to old age. Symptomatic presentations include general ill-health, as well as dermatologic, hematologic, musculoskeletal, mucosal, dental, psychologic and neurologic diseases. Celiac disease has a 95 percent genetic predisposition and, thus, it is frequently associated with autoimmune conditions such as diabetes mellitus type 1 and thyroid disease. Untreated patients have an increased incidence of osteoporosis and intestinal lymphoma. Excellent diagnostic screening tests are now available, including those that detect antigliadin and antiendomysial antibodies. Therapy with a gluten-free diet is effective, resulting in complete resolution of symptoms and secondary complications in almost all patients. Local and national celiac-sprue associations facilitate care of patients with celiac disease and support dietary compliance.
乳糜泻是一种由遗传因素介导的免疫性小肠肠病，可导致吸收不良。针对麸质的免疫炎症反应常常会对身体的许多其他组织造成损害。由于其表现形式多样，这种疾病常常被漏诊。新的患病率数据表明，有症状的和潜在的乳糜泻在每300名欧洲血统的人中就有1例。发病年龄从婴儿期到老年期不等。有症状的表现包括总体健康状况不佳，以及皮肤病、血液学疾病、肌肉骨骼疾病、黏膜疾病、牙科疾病、心理疾病和神经疾病。乳糜泻有95%的遗传易感性，因此它常常与自身免疫性疾病如1型糖尿病和甲状腺疾病相关。未经治疗的患者患骨质疏松症和肠道淋巴瘤的几率会增加。现在有出色的诊断筛查测试，包括那些能检测抗麦醇溶蛋白抗体和抗肌内膜抗体的测试。采用无麸质饮食疗法是有效的，几乎能使所有患者的症状和继发性并发症完全消除。地方和国家的乳糜泻协会为乳糜泻患者的护理提供便利，并支持饮食依从性。
