Celiac disease:diagnostic criteria in progress

作     者：U Volta V Villanacci 

作者机构：Department of Clinical MedicineSt Orsola-Malpighi University HospitalBolognaItaly Department of PathologySpedali CiviliBresciaItaly 

出 版 物：《Cellular & Molecular Immunology》 (中国免疫学杂志（英文版）)

年 卷 期：2011年第8卷第2期

页      面：96-102页

核心收录：

学科分类：0710[理学-生物学] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：celiac disease clinical presentation diagnostic criteria histology,genetics serology 

摘      要：Until a few years ago,celiac disease(CD)was thought to be a rare food intolerance that was confined to childhood and characterized by severe malabsorption and flat intestinal ***,CD is regarded as an autoimmune disorder that is common in the general population(affecting 1 in 100 individuals),with possible onset at any age and with many possible *** identification of CD is challenging because it can begin not only with diarrhea and weight loss but also with atypical gastrointestinal(constipation and recurrent abdominal pain)and extra-intestinal symptoms(anemia,raised transaminases,osteoporosis,recurrent miscarriages,aphthous stomatitis and associated autoimmune disorders),or it could be completely *** the last 20 years,the diagnostic accuracy of serology for CD has progressively increased with the development of highly reliable tests,such as the detection of IgA tissue transglutaminase and antiendomysial and IgG antideamidated gliadin peptide *** routine use of antibody markers has allowed researchers to discover a very high number of‘borderline’cases,characterized by positive serology and mild intestinal lesions or normal small intestine architecture,which can be classified as potential ***,it is evident that the‘old celiac disease’with flat mucosa is only a part of the spectrum of *** is possible that serology could identify CD in its early stages,before the appearance of severe intestinal *** cases with a positive serology but with mild or absent intestinal lesions,the detection of HLA-DQ2 and HLA-DQ8 can help reinforce or exclude the diagnosis of gluten sensitivity.