临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (10): 729-.doi: 10.3969/j.issn.1000-3606.2017.10.003

• 消化系统疾病专栏 • 上一篇    下一篇

儿童乳糜泻 2 例临床分析

马昕 1, 钟雪梅 1, 张艳玲 1, 宁慧娟 1, 朱丹 1, 宫幼喆 1, 邹继珍 2   

  1. 首都儿科研究所附属儿童医院1.消化内科,2.病理科(北京 100020)
  • 收稿日期:2017-10-15 出版日期:2017-10-15 发布日期:2017-10-15
  • 通讯作者: 钟雪梅 E-mail:zhongxuemei 5566@163.com

Clinical manifestations of celiac disease in two children

 MA Xin1, ZHONG Xuemei1, ZHANG Yanling1, NING Huijuan1,  ZHU Dan1, GONG Youzhe1, ZOU Jizhen2   

  1. 1. Department of Gastroenterology, 2. Department of Pathology, Hospital of Capital Institute of Pediatrics, Beijing 100020, China
  • Received:2017-10-15 Online:2017-10-15 Published:2017-10-15

摘要: 目的 探讨儿童乳糜泻的诊断及治疗。方法 回顾分析2例乳糜泻患儿的临床资料。结果 2例患儿均为男 性,分别为8岁、 2岁,均以慢性腹泻、营养不良为主要表现,合并有贫血、低白蛋白血症。大便苏丹Ⅲ染色阳性,抗肌内膜 抗体IgA、抗麦胶蛋白IgA阳性。内镜检查发现十二指肠及小肠黏膜病变;病理均提示小肠绒毛萎缩,隐窝上皮内淋巴细 胞浸润,黏膜固有层中多量淋巴细胞及浆细胞浸润。 2例患儿给予避免麸质饮食后腹泻很快好转,体质量明显增加。但其 中1例未能坚持免麸质饮食,腹泻出现反复。结论 儿童乳糜泻在中国少见,需早期诊断及治疗,应严格终生无麸质饮食。

Abstract:  Objective To explore the diagnosis and treatment of celiac disease in children. Method The clinical data of 2 children with celiac disease were analyzed retrospectively. Results Both of them were 8-year and 2-year-old males. Chronic diarrhea and malnutrition were the main manifestations combined with anemia and hypoalbuminemia in both of them. The examinations showed that stool Sultan III staining, anti-endometrial antibody IgA, and anti-gliadin IgA were all positive. Endoscopic examination revealed mucosal lesions in duodenal and small bowel. Pathology showed small intestinal villus atrophy, infiltration of lymphocytes in crypt epithelium, and infiltration of lymphocytes and plasma cells in the lamina propria. Diarrhea was quickly improved in both of them after the gluten diet was avoided, and weight increased significantly. However, one of them failed to maintain a gluten free diet and diarrhea recurred. Conclusions The celiac disease in children is rare in China. It needs to have early diagnosis and treatment, and should be strictly followed by a lifelong gluten free diet.