目前接受的方法是积极地进行病例追查,对乳糜泻的许多潜在表现保持警惕,并降低血清学检测的门槛。也许最需要关注的群体是在一级亲属中有乳糜泻患者的幼儿,因为约 7% 的乳糜泻发病风险是相当大的,而且延迟诊断可能会永久性地损害患儿的生长潜力。因此,可以考虑对有风险的儿童在症状发作前进行血清学测定。精心设计的随机临床试验表明,对于有乳糜泻家族史的儿童,母乳喂养或添加含麸质饮食的时间点的选择并不会改变其患乳糜泻的风险。[61]Vriezinga SL, Auricchio R, Bravi E, et al. Randomized feeding intervention in infants at high risk for celiac disease. N Engl J Med. 2014 Oct 2;371(14):1304-15.http://www.nejm.org/doi/full/10.1056/NEJMoa1404172http://www.ncbi.nlm.nih.gov/pubmed/25271603?tool=bestpractice.com[62]Lionetti E, Castellaneta S, Francavilla R, et al. Introduction of gluten, HLA status, and the risk of celiac disease in children. N Engl J Med. 2014 Oct 2;371(14):1295-303.http://www.nejm.org/doi/full/10.1056/NEJMoa1400697http://www.ncbi.nlm.nih.gov/pubmed/25271602?tool=bestpractice.com[63]Pinto-Sánchez MI, Verdu EF, Liu E, et al. Gluten introduction to infant feeding and risk of celiac disease: systematic review and meta-analysis. J Pediatr. 2016 Jan;168:132-43.http://www.jpeds.com/article/S0022-3476%2815%2901045-8/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/26500108?tool=bestpractice.com