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Coeliac disease.
The Lancet ( IF 98.4 ) Pub Date : 2018-01-06 , DOI: 10.1016/s0140-6736(17)31796-8
Benjamin Lebwohl , David S Sanders , Peter H R Green

Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations. Diagnosis requires the presence of duodenal villous atrophy, and most patients have circulating antibodies against tissue transglutaminase; in children, European guidelines allow a diagnosis without a duodenal biopsy provided that strict symptomatic and serological criteria are met. Although a gluten-free diet is an effective treatment in most individuals, a substantial minority develop persistent or recurrent symptoms. Difficulties adhering to a gluten-free diet have led to the development of non-dietary therapies, several of which are undergoing trials in human beings.

中文翻译:

腹腔疾病。

在大多数人群中,腹腔疾病发生在大约1%的人群中。诊断率正在增加,这似乎是由于发病率的真正上升而不是认识和检测的增加。乳糜泻在遗传易感个体中发展,这些个体对未知的环境因素做出反应后会产生一种免疫反应,随后会由于摄入麸质而引发这种免疫反应。该疾病有许多临床表现,从严重的吸收不良到最小程度的有症状或无症状表现。诊断需要存在十二指肠绒毛萎缩,并且大多数患者具有针对组织转谷氨酰胺酶的循环抗体。对于儿童,只要符合严格的症状和血清学标准,欧洲指南允许在不进行十二指肠活检的情况下进行诊断。尽管无麸质饮食在大多数人中是有效的治疗方法,但相当一部分人会出现持续性或复发性症状。坚持无麸质饮食的困难导致了非饮食疗法的发展,其中有几种正在人类中进行试验。
更新日期:2018-01-05
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