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This guideline presents recommendations for the management of coeliac disease (CD) and other gluten-related disorders both in adults and children. There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed.
Recommendations about potential, silent, and seronegative celiac disease. GFD: Gluten-free diet; HLA: Human leukocytes antigen. Silent CD is characterised by the presence of both positive serology and histology for CD in the absence of classical or non-classical symptoms.
Non-celiac gluten sensitivity, a condition in which individuals do not have the diagnostic features of CD but nonetheless develop celiac-like symptoms upon exposure to dietary gluten, is important to consider in the differential diagnosis of CD (70, 145, 146).
14 lut 2023 · Celiac disease should be differentiated from nonceliac gluten sensitivity in order to identify the risk for nutritional deficiency and complications of celiac disease and to determine the necessary degree and duration of adherence to a gluten-free diet.
In adults, all guidelines, including the American College of Gastroenterology guidelines, 21 recommend screening with celiac antibody testing and, if positive, performing a biopsy in populations with a low prevalence (<5%) of CD.
Diagnostic criteria include the presence of symptoms similar to those of celiac or allergic patients; negative allergological tests and absence of anti-tTG and EMA antibodies; normal duodenal histology; evidence of disappearance of the symptoms with a gluten-free diet; relapse of the symptoms when gluten is reintroduced.
The criteria for the diagnosis of celiac disease are changing, but in adults, diagnosis still depends on the presence of duodenal villous atrophy while the patient is on a gluten-containing diet, along with findings from serology analysis.
