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Follow-up of Celiac Disease After Diagnosis
Luca Elli1, Govind K Makharia2, Daniel A Leffler3
1Department of Pathophysiology and Transplantation, Universita' degli Studi di Milano, Milano, Italy; Center for Prevention and Diagnosis of Celiac Disease-Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Abstract:
Follow-up of celiac disease (CeD) after diagnosis includes dietician education and assessment of gluten-free diet (GFD) adherence promoting resolution of symptoms, mucosal injury, and can reduce the risk of comorbidities including osteopenia, autoimmune diseases, and malignant complications. As a consequence, regular follow-up of CeD should include assessment of clinical response, GFD adherence, and CeD activity (ie, mucosal healing). This includes regular clinical evaluation and blood tests to check biological abnormalities resolution, in particular confirming correction of anemia and vitamin deficiencies. Villous recovery has a prognostic value, and follow-up duodenal biopsy is central to the investigation of unresponsive CeD.
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