Is it worth investigating splenic function in patients with celiac disease?

Area of Science:

• Immunology
• Gastroenterology
• Hematology

Background:

• Celiac disease is an immune-mediated enteropathy triggered by gluten in susceptible individuals.
• Spleen dysfunction (hypofunction or atrophy) is common in celiac disease, affecting over a third of adults.
• Impaired splenic function elevates risks for encapsulated bacterial infections, thromboembolic events, and autoimmune disorders, especially with complications like refractory celiac disease or T-cell lymphoma.

Purpose of the Study:

• To critically re-evaluate the clinical and diagnostic aspects of spleen dysfunction in celiac disease.
• To highlight new perspectives for prophylactic infection management in celiac patients with splenic dysfunction.

Main Methods:

• Literature review and critical analysis of existing clinical data.
• Re-evaluation of diagnostic criteria for spleen dysfunction in celiac disease.
• Assessment of current prophylactic strategies for infections in celiac patients.

Main Results:

• Spleen dysfunction is a frequent complication of celiac disease, often unaddressed in clinical practice.
• Current management protocols for celiac disease do not routinely assess splenic function.
• Prophylactic vaccinations against encapsulated bacteria are not standard for celiac patients with significant hyposplenism or splenic atrophy.

Conclusions:

• Spleen dysfunction is a significant, often overlooked, complication of celiac disease with serious health implications.
• There is a need to integrate splenic function assessment into the routine management of celiac disease.
• Developing improved prophylactic strategies, including vaccination, is crucial for managing infection risk in celiac patients with spleen dysfunction.