摘要
在过去,乳糜泻被相信是长期的肠病,几乎只影响欧洲起源的人。新、简单、很敏感、特定的血清学的测试的可获得性(反麦胶蛋白质, anti-endomysium 和反-- transglutaminase 抗体试金)证明了那乳糜泻不仅在欧洲并且在欧洲祖先的人而且在主要主食食谱是小麦的发展中的国家是普通的(南部的亚洲,中东,北方韦斯特和东非,南美洲),在一般人口并且在在风险的组。面筋不耐因此看起来是一个普遍公共卫生问题和了解和临床的怀疑的增加的水平在医生们必须学会认出乳糜泻的可变临床的演讲(古典、不正常、沉默的形式) 的新世界上被需要。在发展中的国家,在一般人口并且在风险的在组的血清学的测试的两血清学的屏蔽为腹的病人的早鉴定是必要的。没有面筋的食谱在发展中的国家提出一个挑战性的公共卫生问题,特别自从商业没有面筋的产品不是可得到的。
In the past, celiac disease was believed to be a chronic enteropathy, almost exclusively affecting people of European origin. The availability of new, simple, very sensitive and specific serological tests (anti-gliadin, anti- endomysium and anti-transglutaminase antibody assays) have shown that celiac disease is common not only in Europe and in people of European ancestry but also in the developing countries where the major staple diet is wheat (Southern Asia, the Middle East, North West and East Africa, South America), both in the general population and in the groups at risk. Gluten intolerance thus appears to be a widespread public health problem and an increased level of awareness and clinical suspicion are needed in the New World where physicians must learn to recognize the variable clinical presentations (classical, atypical and silent forms) of celiac disease. In the developing countries, both serological screening in the general population and serological testing in groups at risk are necessary for an early identification of celiac patients. The gluten-free diet poses a challenging public health problem in the developing countries, especially since commercial gluten-free products are not available.