Review article: Systemic consequences of coeliac disease

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Immunology

Background:

• Coeliac disease (CD) often manifests with gastrointestinal symptoms, but also presents with diverse systemic effects.
• These extra-intestinal manifestations can lead to permanent damage if CD remains undiagnosed or treatment is delayed.
• Scientific evidence for many systemic consequences of CD is limited and often contradictory.

Purpose of the Study:

• To review the most studied and clinically significant systemic consequences of coeliac disease.
• To highlight manifestations that can be prevented or managed through early CD diagnosis.
• To provide guidance for physicians managing patients with coeliac disease.

Main Methods:

• Conducted a narrative review of existing literature.
• Focused on thoroughly studied and clinically relevant systemic consequences of coeliac disease.
• Prioritized conditions potentially impacted by early diagnosis and intervention.

Main Results:

• Systemic consequences of CD affect multiple organ systems, notably skeletal, reproductive, cardiovascular, and neurological systems.
• Coeliac disease is linked to increased risks of psychiatric disorders, non-Hodgkin lymphoma, and intestinal adenocarcinoma.
• Evidence for some systemic manifestations is scant, necessitating further research.

Conclusions:

• Systemic consequences significantly impact the overall health of coeliac disease patients.
• Early diagnosis and a gluten-free diet benefit most, but not all, systemic conditions.
• Metabolic and psychosocial impacts of the gluten-free diet require consideration during patient follow-up.