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Celiac Disease
Amy S Oxentenko1, Alberto Rubio-Tapia1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Insights
Celiac disease (CD), affecting 1% of the population, requires a high index of suspicion for diagnosis. Early and accurate diagnosis of this multisystem disorder is crucial for effective management with a gluten-free diet.
Area of Science:
- Gastroenterology
- Immunology
- Genetics
Background:
- Celiac disease (CD) affects approximately 1% of the population, with most cases undiagnosed.
- CD is a multisystem disorder with varied clinical presentations, necessitating a high index of suspicion.
- Accurate diagnosis is critical due to the lifelong gluten-free diet management.
Purpose of the Study:
- To provide clinicians with current information on diagnosing and managing celiac disease.
- To cover new developments and controversial issues in celiac disease management.
- To emphasize the importance of correct diagnosis for lifelong gluten-free diet adherence.
Main Methods:
- Review of current literature on celiac disease diagnosis and management.
- Analysis of diagnostic criteria including clinical features, serology, and duodenal biopsies.
- Discussion of differential diagnoses and management strategies.
Main Results:
- Diagnosis relies on genetic predisposition, clinical features, specific serologic findings, and duodenal enteropathy.
- Improvement on a gluten-free diet supports the diagnosis.
- Numerous differential diagnoses must be considered.
Conclusions:
- Accurate diagnosis of celiac disease is paramount for effective lifelong management.
- Clinicians need updated information on diagnostic approaches and controversial aspects of CD.
- A multidisciplinary approach considering genetics, clinical presentation, and histology is essential.
Abstract:
Celiac disease (CD) affects approximately 1% of the general population, although most cases remain unrecognized. Because CD is a multisystem disorder with protean clinical manifestations, a high index of suspicion is needed to make an appropriate diagnosis. A diagnosis of CD is made in a patient who is genetically predisposed based on the presence of compatible clinical features, positive highly specific celiac serologic findings, duodenal biopsies that document enteropathy, and improvement with a gluten-free diet. The differential diagnoses for the clinical features and the histologic findings seen in patients with CD are numerous and need to be considered; because the management of celiac disease consists of a lifelong gluten-free diet, ensuring that the diagnosis is correctly established is of utmost importance. The aim of this review is to provide practicing clinicians with the most current information on the diagnosis and management of CD, including new developments and the approach to controversial issues.
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