[Screening for celiac disease in high risk groups].

Area of Science:

• Gastroenterology
• Epidemiology
• Immunology

Context:

• Celiac disease diagnosis is often missed, particularly in patients without typical gastrointestinal symptoms.
• Extraintestinal manifestations of celiac disease are significantly more common than intestinal ones.
• The "celiac iceberg" model highlights the disparity between diagnosed and undiagnosed cases.

Purpose:

• To emphasize the prevalence of extraintestinal manifestations in celiac disease.
• To discuss the "celiac iceberg" model and its implications for diagnosis.
• To advocate for systematic screening of at-risk groups to identify undiagnosed celiac disease.

Summary:

• Epidemiological data indicate that celiac disease with extraintestinal manifestations is substantially more frequent than with intestinal symptoms.
• The "celiac iceberg" model illustrates that for every diagnosed celiac patient, 5-10 remain undiagnosed, often presenting with silent or monosymptomatic disease.
• Systematic screening of individuals in known risk groups is the primary strategy for uncovering the "submerged" portion of the celiac iceberg.

Impact:

• Increased awareness of celiac disease's diverse presentations beyond gastrointestinal issues.
• Improved diagnostic strategies for celiac disease, particularly for silent and monosymptomatic forms.
• Potential for earlier diagnosis and intervention, reducing long-term complications associated with untreated celiac disease.