ผลต่างระหว่างรุ่นของ "โรคของซีลิแอ็ก"

แก้วันที่
(ปรับข้อมูลและสำนวน)
(แก้วันที่)
{{cite web | title = Dermatitis Herpetiformis | url = http://www.aocd.org/skin/dermatologic_diseases/dermatitis_herpeti.html | publisher = American Osteopathic College of Dermatology | deadurl = no | archiveurl = https://web.archive.org/web/20181029104404/https://www.aocd.org/page/DermatitisHerpetifo | archivedate = 2018-10-29 }}</ref>
}}<!--*** จบเชิงอรรถ ***--><ref name=Fasano2005Pediatric/><ref name=SymptomsCausesNIDDK>
{{cite web | title = Symptoms & Causes of Celiac Disease {{!}} NIDDK | url = https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes | website = National Institute of Diabetes and Digestive and Kidney Diseases | accessdate = 2017-04-24 | date = June 2016-06 | deadurl = no | archiveurl = https://web.archive.org/web/20170424175500/https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes | archivedate = 2017-04-24}}</ref>
| complications = [[ภาวะเลือดจางเหตุขาดธาตุเหล็ก]] ภาวะกระดูกพรุน เป็นหมัน [[มะเร็ง]]ต่าง ๆ ปัญหาทางประสาท และ[[โรคภูมิต้านตนเอง]]อื่น ๆ<ref name=Leb2015/><ref name=Lund2015/><ref name=WGO2016>
{{cite web | url = http://www.worldgastroenterology.org/guidelines/global-guidelines/celiac-disease/celiac-disease-english | title = Celiac disease | date = July 2016-07 | publisher = World Gastroenterology Organisation Global Guidelines | accessdate = 2017-04-23 | deadurl = no | archiveurl = https://web.archive.org/web/20170317123604/http://www.worldgastroenterology.org/guidelines/global-guidelines/celiac-disease/celiac-disease-english | archivedate = 2017-03-17}}</ref><ref name=Cic2015/><ref name=LionettiFrancavilla2010>
{{cite journal | authors = Lionetti, E; Francavilla, R; Pavone, P; Pavone, L; Francavilla, T; Pulvirenti, A; Giugno, R; Ruggieri, M | title = The neurology of coeliac disease in childhood: what is the evidence? A systematic review and meta-analysis | journal = Developmental Medicine and Child Neurology | volume = 52 | issue = 8 | pages = 700-7 | date = August 2010-08 | pmid = 20345955 | doi = 10.1111/j.1469-8749.2010.03647.x }} {{open access}}</ref>
| onset = ไม่จำกัดอายุ<ref name=Fasano2005Pediatric/><ref name=ESPGHAN2012 />
| duration = เป็นตลอดชีวิต<ref name=Cic2015 />
แม้โรคอาจเริ่มตั้งแต่วัยเด็ก<ref name=Cic2015>
{{cite journal | authors = Ciccocioppo, R; Kruzliak, P; Cangemi, GC; Pohanka, M; Betti, E; Lauret, E; Rodrigo, L | title = The Spectrum of Differences between Childhood and Adulthood Celiac Disease | journal = Nutrients | volume = 7 | issue = 10 | pages = 8733-51 | date = 2015-10-22 | pmid = 26506381 | pmc = 4632446 | doi = 10.3390/nu7105426 | type = Review | quote = Several additional studies in extensive series of coeliac patients have clearly shown that TG2A sensitivity varies depending on the severity of duodenal damage, and reaches almost 100% in the presence of complete villous atrophy (more common in children under three years), 70% for subtotal atrophy, and up to 30% when only an increase in IELs is present. ''(IELs: intraepithelial lymphocytes)''}}</ref><ref name=ESPGHAN2012>
{{cite journal | authors = Husby, S; Koletzko, S; Korponay-Szabó, IR; Mearin, ML; Phillips, A; Shamir, R; Troncone, R; Giersiepen, K; Branski, D; Catassi, C; Lelgeman, M; Mäki, M; Ribes-Koninckx, C; Ventura, A; Zimmer, KP; ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, Nutrition | title = European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease | journal = J Pediatr Gastroenterol Nutr | volume = 54 | issue = 1 | pages = 136-60 | date = January 2012-01 | pmid = 22197856 | url = http://www.espghan.org/fileadmin/user_upload/guidelines_pdf/Guidelines_2404/European_Society_for_Pediatric_Gastroenterology_.28__1_.pdf | doi = 10.1097/MPG.0b013e31821a23d0 | type = Practice Guideline | quote = Since 1990, the understanding of the pathological processes of CD has increased enormously, leading to a change in the clinical paradigm of CD from a chronic, gluten-dependent enteropathy of childhood to a systemic disease with chronic immune features affecting different organ systems. (...) atypical symptoms may be considerably more common than classic symptoms | deadurl = no | archiveurl = https://web.archive.org/web/20160403065800/http://www.espghan.org/fileadmin/user_upload/guidelines_pdf/Guidelines_2404/European_Society_for_Pediatric_Gastroenterology_.28__1_.pdf | archivedate = 2016-04-03}}</ref>
แต่ก็เกิดเมื่ออายุเท่าไรก็ได้<ref name=Fasano2005Pediatric>{{cite journal | author = Fasano, A | title = Clinical presentation of celiac disease in the pediatric population | journal = Gastroenterology | volume = 128 | issue = 4 Suppl 1 | pages = S68-73 | date = April 2005-04 | pmid = 15825129 | doi = 10.1053/j.gastro.2005.02.015 | type = Review}}</ref><ref name=ESPGHAN2012 />
โรคมักสัมพันธ์กับโรคภูมิต้านตนเองอื่น ๆ เช่น [[โรคเบาหวานประเภทที่ 1]] และต่อมไทรอยด์อักเสบเป็นต้น<ref name=Cic2015 />
 
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โรคเกิดจากปฏิกิริยาของร่างกายต่อ[[กลูเตน]] ซึ่งเป็นโปรตีนต่าง ๆ ที่พบใน[[ข้าวสาลี]]และข้าวประเภทอื่น ๆ รวมทั้ง[[ข้าวบาร์เลย์]]และ[[ข้าวไรย์]]<ref name=TovoliMasi2015>
{{cite journal | authors = Tovoli, F; Masi, C; Guidetti, E; Negrini, G; Paterini, P; Bolondi, L | title = Clinical and diagnostic aspects of gluten related disorders | journal = World Journal of Clinical Cases | volume = 3 | issue = 3 | pages = 275-84 | date = March 2015-03 | pmid = 25789300 | pmc = 4360499 | doi = 10.12998/wjcc.v3.i3.275 | type = Review }}</ref><ref name=PenaginiDilillo2013>
{{cite journal | authors = Penagini, F; Dilillo, D; Meneghin, F; Mameli, C; Fabiano, V; Zuccotti, GV | title = Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet | journal = Nutrients | volume = 5 | issue = 11 | pages = 4553-65 | date = November 2013-11 | pmid = 24253052 | pmc = 3847748 | doi = 10.3390/nu5114553 | type = Review }}</ref><ref name=Lancet2009>
{{cite journal | authors = Di Sabatino, A; Corazza, GR | title = Coeliac disease | journal = Lancet | volume = 373 | issue = 9673 | pages = 1480-93 | date = April 2009-04 | pmid = 19394538 | doi = 10.1016/S0140-6736(09)60254-3 }}</ref>
ปกติคนไข้สามารถรับ[[ข้าวโอ๊ต]]ที่ไม่มากเกินโดยไม่เจือปนกับข้าวที่มีกลูเตนอื่น ๆ ได้<ref name=PenaginiDilillo2013 /><ref>{{cite journal | authors = Pinto-Sánchez, MI; Causada-Calo, N; Bercik, P; Ford, AC; Murray, JA; Armstrong, D; Semrad, C; Kupfer, SS; Alaedini, A; Moayyedi, P; Leffler, DA; Verdú, EF; Green, P | title = Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies | journal = Gastroenterology | volume = 153 | issue = 2 | pages = 395-409.e3 | date = August 2017-08 | pmid = 28431885 | doi = 10.1053/j.gastro.2017.04.009 }}</ref>
แต่ก็อาจมีปัญหากับข้าวโอ๊ตบางสายพันธุ์<ref name=PenaginiDilillo2013 /><ref name=CominoMoreno2015>{{cite journal | authors = Comino, I; Moreno, M; Sousa, C | title = Role of oats in celiac disease | journal = World Journal of Gastroenterology | volume = 21 | issue = 41 | pages = 11825-31 | date = November 2015-11 | pmid = 26557006 | pmc = 4631980 | doi = 10.3748/wjg.v21.i41.11825 | quote = It is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet. }}</ref>
เป็นโรคที่เกิดกับผู้มีปัญหาทาง[[พันธุกรรม]]<ref name=NIH2015>{{cite web | title = Celiac Disease | url = http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx | website = NIDDKD | accessdate = 2016-03-17 | date = June 2015-06 | deadurl = no | archiveurl = https://web.archive.org/web/20160313222154/http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx | archivedate = 2016-03-13}}</ref>
คือ เมื่อได้รับกลูเตน การตอบสนองผิดปกติของ[[ระบบภูมิคุ้มกัน]]จะผลิตสารภูมิต้านทานต้านตนเอง (autoantibody) ซึ่งอาจสร้างปัญหาแก่อวัยวะต่าง ๆ<ref name=Lund2015>{{cite journal | authors = Lundin, KE; Wijmenga, C | title = Coeliac disease and autoimmune disease-genetic overlap and screening | journal = Nature Reviews. Gastroenterology & Hepatology | volume = 12 | issue = 9 | pages = 507-15 | date = September 2015-09 | pmid = 26303674 | doi = 10.1038/nrgastro.2015.136 | type = Review | quote = The abnormal immunological response elicited by gluten-derived proteins can lead to the production of several different autoantibodies, which affect different systems. }}</ref><ref name=NICEcoeliac>{{NICE |86|Recognition and assessment of coeliac disease|2015}}</ref>
ในลำไส้เล็ก นี่ทำให้อักเสบ และอาจทำส่วนยื่นที่บุลำไส้ (intestinal villus) ให้สั้น/ทื่อลง เป็นอาการที่เรียกว่า villous atrophy<ref name=NIH2015/><ref name=VivasVaquero2015>{{cite journal | authors = Vivas, S; Vaquero, L; Rodríguez-Martín, L; Caminero, A | title = Age-related differences in celiac disease: Specific characteristics of adult presentation | journal = World Journal of Gastrointestinal Pharmacology and Therapeutics | volume = 6 | issue = 4 | pages = 207-12 | date = November 2015-11 | pmid = 26558154 | pmc = 4635160 | doi = 10.4292/wjgpt.v6.i4.207 | type = Review | quote = In addition, the presence of intraepithelial lymphocytosis and/or villous atrophy and crypt hyperplasia of small-bowel mucosa, and clinical remission after withdrawal of gluten from the diet, are also used for diagnosis antitransglutaminase antibody (tTGA) titers and the degree of histological lesions inversely correlate with age. Thus, as the age of diagnosis increases antibody titers decrease and histological damage is less marked. It is common to find adults without villous atrophy showing only an inflammatory pattern in duodenal mucosa biopsies: Lymphocytic enteritis (Marsh I) or added crypt hyperplasia (Marsh II) }}</ref>
ซึ่งทำให้ดูดซึมอาหารได้น้อยลง และบ่อยครั้งทำให้[[โลหิตจาง]]<ref name=NIH2015/><ref name=Lancet2009/>
 
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[[การวินิจฉัยทางการแพทย์|การวินิจฉัย]]จะอาศัยการตรวจสารภูมิต้านทานในเลือดบวกกับการตัดเนื้อลำไส้ออกตรวจ โดยการทดสอบทางพันธุกรรม (genetic testing) โดยเฉพาะอาจช่วย<ref name=NIH2015/>
แต่บางครั้งก็วินิจฉัยได้ยาก<ref name=MatthiasPfeiffer2010>{{cite journal | authors = Matthias, T; Pfeiffer, S; Selmi, C; M, Eric Gershwin | title = Diagnostic challenges in celiac disease and the role of the tissue transglutaminase-neo-epitope | journal = Clin Rev Allergy Immunol | volume = 38 | issue = 2-3 | pages = 298-301 | date = April 2010-04 | pmid = 19629760 | doi = 10.1007/s12016-009-8160-z | type = Review}}</ref>
เพราะอาจตรวจไม่พบสารภูมิต้านทานต้านตนเอง (autoantibody)<ref name=LewisScott2006>
{{cite journal | authors = Lewis, NR; Scott, BB | title = Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests) | journal = Alimentary Pharmacology & Therapeutics | volume = 24 | issue = 1 | pages = 47-54 | date = July 2006-07 | pmid = 16803602 | doi = 10.1111/j.1365-2036.2006.02967.x }}</ref><ref name=AGA2006>
{{cite journal | authors = Rostom, A; Murray, JA; Kagnoff, MF | title = American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease | journal = Gastroenterology | volume = 131 | issue = 6 | pages = 1981-2002 | date = December 2006-12 | pmid = 17087937 | url = http://www.gastrojournal.org/article/S0016-5085%2806%2902227-X/fulltext | doi = 10.1053/j.gastro.2006.10.004 | type = Review}}</ref>
เพราะลำไส้เล็กอาจเปลี่ยนไปเพียงเล็กน้อยและส่วนยื่นจะดูปกติ<ref name=RostamiNejadHoggKollars2011 /><ref name=MolinaInfanteSantolaria2015>{{cite journal | authors = Molina-Infante, J; Santolaria, S; Sanders, DS; Fernández-Bañares, F | title = Systematic review: noncoeliac gluten sensitivity | journal = Alimentary Pharmacology & Therapeutics | volume = 41 | issue = 9 | pages = 807-20 | date = May 2015-05 | pmid = 25753138 | doi = 10.1111/apt.13155 | type = Review | quote = Furthermore, seronegativity is more common in coeliac disease patients without villous atrophy (Marsh 1-2 lesions), but these ‘minor’ forms of coeliac disease may have similar clinical manifestations to those with villous atrophy and may show similar clinical-histological remission with reversal of haematological or biochemical disturbances on a gluten-free diet (GFD). }}</ref>
แม้ผู้ที่มีอาการหนักก็อาจต้องไปหาหมอเป็นเวลาหลายปีกว่าจะวินิจฉัยได้ถูกต้อง<ref name=LudvigssonCard2015>{{cite journal | authors = Ludvigsson, JF; Card, T; Ciclitira, PJ; Swift, GL; Nasr, I; Sanders, DS; Ciacci, C | title = Support for patients with celiac disease: A literature review | journal = United European Gastroenterology Journal | volume = 3 | issue = 2 | pages = 146-59 | date = April 2015-04 | pmid = 25922674 | pmc = 4406900 | doi = 10.1177/2050640614562599 | type = Review }}</ref>
ปัจจุบันมีผู้ไม่มีอาการอะไร ๆ ที่วินิจฉัยว่ามีโรคนี้ โดยอาศัยการตรวจคัดโรค<ref name="VanHeelWest">{{cite journal | authors = van Heel, DA; West, J | title = Recent advances in coeliac disease | journal = Gut | volume = 55 | issue = 7 | pages = 1037-46 | date = July 2006-07 | pmid = 16766754 | pmc = 1856316 | doi = 10.1136/gut.2005.075119 | type = Review }}</ref>
แต่หลักฐานซึ่งแสดงประโยชน์ของการตรวจคัดโรคก็ยังไม่ชัดเจน<ref name=USPSTF2017>{{cite journal | authors = Bibbins-Domingo, K; Grossman, DC; Curry, SJ; Barry, MJ; Davidson, KW; Doubeni, CA; Ebell, M; Epling, JW; Herzstein, J; Kemper, AR; Krist, AH; Kurth, AE; Landefeld, CS; Mangione, CM; Phipps, MG; Silverstein, M; Simon, MA; Tseng, CW | title = Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement | journal = JAMA | volume = 317 | issue = 12 | pages = 1252-1257 | date = March 2017-03 | pmid = 28350936 | doi = 10.1001/jama.2017.1462 }}</ref>
แม้โรคจะมีเหตุจากความไม่ทนต่อโปรตีนข้าวสาลี แต่นี่ก็ไม่ใช่[[ภาวะภูมิแพ้ข้าวสาลี]] (wheat allergy)<ref name=NIH2015/>
 
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วิธีการรักษาในปัจจุบันอย่างเดียวก็คือการให้ทานอาหารปลอดกลูเตนตลอดชีวิต ซึ่งอาจทำให้เยื่อลำไส้ฟื้นตัว ทำให้อาการดีขึ้น และลดความเสี่ยง[[ภาวะแทรกซ้อน]]อื่น ๆ ซึ่งได้ผลต่อคนไข้โดยมาก<ref name=SeeKaukinen2015>{{cite journal | authors = See, JA; Kaukinen, K; Makharia, GK; Gibson, PR; Murray, JA | title = Practical insights into gluten-free diets | journal = Nature Reviews. Gastroenterology & Hepatology | volume = 12 | issue = 10 | pages = 580-91 | date = October 2015-10 | pmid = 26392070 | doi = 10.1038/nrgastro.2015.156 | type = Review | quote = A lack of symptoms and/or negative serological markers are not reliable indicators of mucosal response to the diet. Furthermore, up to 30% of patients continue to have gastrointestinal symptoms despite a strict GFD.122,124 If adherence is questioned, a structured interview by a qualified dietitian can help to identify both intentional and inadvertent sources of gluten. }}</ref>
ถ้าไม่รักษา นี่อาจทำให้เกิด[[มะเร็ง]] เช่น [[มะเร็งต่อมน้ำเหลือง]]ของลำไส้ (intestinal lymphoma) และเพิ่มความเสี่ยงการตายก่อนวัยโดยเล็กน้อย<ref name=Leb2015>{{cite journal | authors = Lebwohl, B; Ludvigsson, JF; Green, PH | title = Celiac disease and non-celiac gluten sensitivity | journal = BMJ | volume = 351 | pages = h4347 | date = October 2015-10 | pmid = 26438584 | pmc = 4596973 | doi = 10.1136/bmj.h4347 | quote = Celiac disease occurs in about 1% of the population worldwide, although most people with the condition are undiagnosed. It can cause a wide variety of symptoms, both intestinal and extra-intestinal because it is a systemic autoimmune disease that is triggered by dietary gluten. Patients with coeliac disease are at increased risk of cancer, including a twofold to fourfold increased risk of non-Hodgkin’s lymphoma and a more than 30-fold increased risk of small intestinal adenocarcinoma, and they have a 1.4-fold increased risk of death. | type = Review }}</ref>
อัตราการเกิดโรคไม่เหมือนกันในเขตต่าง ๆ ทั่วโลก เริ่มจาก[[ความชุกโรค]]ที่ 1 คนต่อ 300 คนจนถึง 1 คนต่อ 40 คน โดยเฉลี่ยที่ระหว่าง 1 คนต่อ 100 คน กับ 1 คนใน 170 คน<ref name=NEJM2012>{{cite journal | authors = Fasano, A; Catassi, C | title = Clinical practice. Celiac disease | journal = The New England Journal of Medicine | volume = 367 | issue = 25 | pages = 2419-26 | date = December 2012-12 | pmid = 23252527 | doi = 10.1056/NEJMcp1113994 | type = Review }}</ref>
ใน[[ประเทศพัฒนาแล้ว]] ประเมินว่า คนไข้ 80% ยังไม่ได้วินิจฉัย เพราะมีปัญหากระเพาะลำไส้น้อยมากหรือไม่มีเลย และเพราะไม่รู้เรื่องโรค<ref name=WGO2016 /><ref name=LionettiGatti2015>{{cite journal | authors = Lionetti, E; Gatti, S; Pulvirenti, A; Catassi, C | title = Celiac disease from a global perspective | journal = Best Practice & Research. Clinical Gastroenterology | volume = 29 | issue = 3 | pages = 365-79 | date = June 2015-06 | pmid = 26060103 | doi = 10.1016/j.bpg.2015.05.004 | type = Review }}</ref>
เป็นโรคที่สามัญในหญิงมากกว่าชาย<ref name=His2006>{{cite journal | authors = Hischenhuber, C; Crevel, R; Jarry, B; Mäki, M; Moneret-Vautrin, DA; Romano, A; Troncone, R; Ward, R | title = Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease | journal = Alimentary Pharmacology & Therapeutics | volume = 23 | issue = 5 | pages = 559-75 | date = March 2006-03 | pmid = 16480395 | doi = 10.1111/j.1365-2036.2006.02768.x }}</ref>
คำภาษาอังกฤษว่า coeliac มาจากคำ[[ภาษากรีก]]ว่า κοιλιακός (''koiliakós'', "abdominal" แปลว่า เกี่ยวกับท้อง) โดยเริ่มใช้ตั้งแต่คริสต์ศตวรรษที่ 19 อาศัยงานแปลจากภาษากรีกโบราณเกี่ยวกับโรคของแพทย์ชาวกรีกคือ Aretaeus of Cappadocia<ref name="Aretaeus">{{Cite book | last = Adams F, translator | title = The extant works of Aretaeus, The Cappadocian | url = https://books.google.com/?id=v4gIAAAAIAAJ&pg=PT1&q= | chapter = On The Cœliac Affection | pages = 350-1 | chapterurl = https://books.google.com/books?id=v4gIAAAAIAAJ&pg=PA350#v=onepage&q=&f=false | access-date = 2009-12-01212 | year = 1856 | publisher = Sydenham Society | location = London}}</ref><ref name="Losowsky">{{cite journal | authors = Losowsky, MS | title = A history of coeliac disease | journal = Digestive Diseases | volume = 26 | issue = 2 | pages = 112-20 | year = 2008 | pmid = 18431060 | doi = 10.1159/000116768 }}</ref>
 
== เชิงอรรถ ==
12,100

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