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Diagnostic dilemmas in celiac disease.
Michael X Ma1, Mina John, Geoffrey M Forbes
1Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, WA 6001, Australia.
Expert Review of Gastroenterology & Hepatology
|September 28, 2013
Summary
Celiac disease (CD) diagnosis can be challenging due to varied presentations and evolving diagnostic methods. New assays and algorithms are shifting the traditional reliance on small-bowel histology for celiac disease confirmation.
Area of Science:
- Immunology
- Gastroenterology
- Genetics
Background:
- Celiac disease (CD) is an immune-mediated condition triggered by gluten in genetically susceptible individuals.
- Increasing incidence and varied clinical presentations complicate CD diagnosis.
- Traditional diagnosis relies on serology and small-bowel histology.
Purpose of the Study:
- To review the diagnostic challenges in celiac disease.
- To discuss evolving diagnostic assays and algorithms.
- To evaluate the changing role of small-bowel histology.
Main Methods:
- Literature review of diagnostic approaches for celiac disease.
- Analysis of recent advancements in CD serology and histology interpretation.
- Discussion of clinical dilemmas in CD diagnosis.
Main Results:
- CD diagnosis is often straightforward but can be challenging in specific cases.
- Discrepancies between serology and histology present diagnostic dilemmas.
- New diagnostic tools are modifying the established diagnostic pathways.
- The role of small-bowel biopsy in CD diagnosis is being re-evaluated.
Conclusions:
- Evolving diagnostic criteria and new assays impact celiac disease diagnosis.
- Clinical judgment remains crucial in managing complex CD cases.
- The diagnostic landscape for CD is continuously advancing.
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