11) セリアック病

Celiac Disease

要旨　セリアック病は食事中のグルテンにより生じる自己免疫性疾患である．グルテン過敏性腸炎や栄養障害などの消化管症状に加え，鉄欠乏性貧血，骨粗鬆症，Ⅰ型糖尿病，小脳失調などの消化管外症状が知られ，また無症候性の病態も存在する．長期的には一部の悪性リンパ腫のリスクを高めることから，適切な早期介入が公衆衛生上の課題となっている．欧米での罹患率は約1％だが，本邦での頻度はいまだ不明である．

　Celiac disease is an autoimmune-mediated gastrointestinal disorder, triggered by dietary gluten proteins. Along with the well-known gastrointestinal symptoms of gluten sensitive enteropathy and malnutrition, the extra-gastrointestinal forms of the disease can be identifed;such as iron deficiency anemia, osteoporosis, type Ⅰ diabetes, and cerebellar ataxia. An asymptomatic form of the disease also exists. Patients with celiac disease may carry a long term risk of developing malignant lymphomas, which has encouraged early interventions as a measure based on public health perspectives. The prevalence of the disease in Japan is yet to be clarified, while it is estimated as high as 1％ of the population in Europe and North America.