长期慢性腹泻病因诊断应考虑麦胶性肠病

The Etiology Diagnosis of Long-Term Chronic Diarrhea Should Be Considered for Gluten-Induced Enteropathy

目的探讨麦胶性肠病的临床特征、诊疗方法及误诊原因,以提高其诊治水平。方法对1例长期误诊的麦胶性肠病的临床资料进行回顾性分析。结果本例为高龄女性,反复腹泻2年余,为稀便伴恶臭,每日3～4次,曾在多家医院反复就诊,多次行胃肠镜及血液等检查,均未能够明确诊断,长期给予营养支持治疗。后根据病史和医技检查结果排除其他引起慢性腹泻的疾病,考虑麦胶性肠病,予无麦胶饮食后,患者腹泻迅速缓解。随访7个月,无复发。结论麦胶性肠病临床少见,对长期腹泻伴营养不良且多方检查排除胃肠道器质性病变者,应该警惕该病的可能。

Objective To investigate the clinical characteristics, diagnosis and treatment methods and misdiagnosis causes about gluten-induced enteropathy for raising its diagnosis and treatment level. Methods Clinical data of a patient with gluten-induced enteropathy was retrospectively analyzed. Results The case was an old lady admitted with repeated diarrhea for more than 2 years, and complained with fetid loose stool for 3-4 times daily. The blood check-up, gastroscopy and enteros-copy were done many times in the several hospitals without clear diagnosis, and the long-term nutritional and supported therapy was applied for this period. Then, according to the patient＆#39;s history and check-up results the diagnosis of gluten-induced enter-opathy was made, and the diarrhea was stopped dramatically with the gluten-free diet therapy. The patient＆#39;s condition was well for the 7-month follow-up. Conclusion The gluten-induced enteropathy is rare in the clinical routine, and should be consid-ered for the long-term diarrhea and malnutrition patients without significant organic gastrointestinal disorders.