最后审阅: 28 六月 2021
最后更新: 20 十月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 免疫球蛋白 (IgA) 缺乏症
  • 腹泻
  • 腹胀
  • 腹痛/腹部不适
  • 贫血
  • 疱疹样皮炎

其他诊断因素

  • 家族史
  • 骨质减少/骨质疏松症
  • 疲劳
  • 体重减轻
  • 生长迟缓
  • 1 型糖尿病
  • 自身免疫性甲状腺病
  • 口疮性口炎
  • 牙轴质发育不全
  • 容易出现瘀伤
  • 周围神经病
  • 共济失调
  • 不明原因的血清转氨酶水平升高

危险因素

  • 乳糜泻家族史
  • 免疫球蛋白 A 缺乏症
  • 1 型糖尿病
  • 自身免疫性甲状腺病
  • 唐氏综合征
  • 干燥综合征
  • 炎症性肠病
  • 原发性胆汁性胆管炎

诊断性检查

首要检查

  • 全血细胞计数和血涂片
  • 抗组织转谷氨酰胺酶 IgA 抗体 (IgA-tTG)
  • 肌内膜抗体 (EMA)
  • 皮肤活检
  • 去酰胺醇溶蛋白肽 (DGP) IgG 或者 DGP IgA/IgG
  • IgG-tTG
  • 小肠镜检查
  • 小肠组织学检查

需考虑的检查

  • 人类白细胞抗原 (HLA) 分型
  • 麸质激发试验
  • 电视胶囊内镜检查

治疗流程

撰稿人

作者

Amelie Therrien, MD

Clinical Research Fellow in Celiac Disease

Harvard Medical School

Beth Israel Deaconess Medical Center

Boston

MA

利益声明

AT declares that she has no competing interests.

Ciaran P. Kelly, MD
Ciaran P. Kelly

Professor of Medicine

Harvard Medical School

Beth Israel Deaconess Medical Center

Boston

MA

利益声明

CPK is a scientific advisor/consultant for Cour Pharma, Glutenostics, Immunogenx, Innovate, and Takeda Pharmaceuticals. He is an investigator for Aptalis and Takeda, and has stock options in Cour Pharma and Glutenostics. CPK is also a co-author of several references cited in this topic.

鸣谢

Dr Amelie Therrien and Professor Ciaran P. Kelly would like to gratefully acknowledge Dr Daniel A. Leffler, a previous contributor to this topic.

利益声明

DAL declares that he has no competing interests.

同行评议者

Matthew Kurien, PGDip MedSci, MD, MBChB, MRCP

Senior Clinical Lecturer and Honorary Consultant Gastroenterologist

Department of Infection, Immunity & Cardiovascular Disease

Sheffield Medical School

Sheffield

UK

利益声明

MK declares that he has no competing interests.

Eli D. Ehrenpreis, MD

Professor of Medicine

Rosalind Franklin Medical School

Chicago

IL

利益声明

EDE declares that he has no competing interests.

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