小结
定义
病史和体格检查
关键诊断因素
- 长期暴露于疾病流行区
- 全身性症状
- 腹泻
- 腹胀
- 大便恶臭、油腻
- 舌炎
- 手指和足趾麻木
其他诊断因素
- 腹部绞痛
- 发热
- 腿肿胀
- 脱发
- 唇炎/口角口腔黏膜炎
- 足部水肿
- 肠鸣音过度活跃/肠鸣音
- 色素过度沉着/湿疹性皮疹
- 苍白
- 干眼
- 角膜干燥病
- 夜盲症
- 深腱反射减弱/震颤感减退
危险因素
- 长期暴露于疾病流行区
- Aw-19 系列中的 HLA 抗原
诊断性检查
首要检查
- 全血细胞计数 (FBC）
- 粪便脂肪定量测定
- 右旋木糖试验
- 血清叶酸
- 血清维生素 B12
需考虑的检查
- 粪便虫卵和寄生虫试验（O 和 P）
- 粪便培养
- 上消化道内镜及活检
- 叶酸治疗试验
治疗流程
热带性口炎性腹泻症状
撰稿人
作者
Daniel Wild, MD
Professor of Medicine
Division of Gastroenterology
Duke University Medical Center
Durham
NC
利益声明
DW declares that he has no competing interests.
Iris L. Vance, MD
Assistant Professor of Medicine
Division of Gastroenterology
Duke University Medical Center
Durham
NC
利益声明
ILV declares that she has no competing interests.
鸣谢
Dr Daniel Wild and Dr Iris L. Vance would like to gratefully acknowledge Dr Moises Guelrud, a previous contributor to this topic. MG declares that he has no competing interests.
同行评议者
J. Thomas LaMont, MD
Professor of Medicine
Harvard Medical School
Division of Gastroenterology
Beth Israel Deaconess Medical Center
Boston
MA
利益声明
JTLM declares that he has no competing interests.
Daniel Leffler, MD, MS
Instructor in Medicine
Harvard Medical School
Director of Clinical Research
The Celiac Center
Beth Israel Deaconess Medical Center
Boston
MA
利益声明
DL declares that he has no competing interests.
Paul Ciclitira, MBBS, MD, PhD
Professor of Gastroenterology
Department of Diabetes and Nutritional Sciences
King's College London
Rayne Institute
St Thomas' Hospital
London
UK
利益声明
PC declares that he has no competing interests.
鉴别诊断
- 寄生虫感染：类圆线虫、等孢球虫、兰伯贾第虫、溶组织内阿米巴、环孢子虫感染
- 细菌感染：志贺菌、沙门菌、大肠杆菌
- HIV 肠炎
更多 鉴别诊断指南
- 美国胃肠道内镜学会消化掉内镜操作知情同意指南
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明