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European Journal of Pediatrics
Published in: European Journal of Pediatrics 7/2012

Open Access 01-07-2012 | Review

Clinical practice

Coeliac disease

Authors: C. M. Frank Kneepkens, B. Mary E. von Blomberg

Published in: European Journal of Pediatrics | Issue 7/2012

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Abstract

Coeliac disease (CD) is an immune-mediated systemic condition elicited by gluten and related prolamines in genetically predisposed individuals and characterised by gluten-induced symptoms and signs, specific antibodies, a specific human leukocyte antigen (HLA) type and enteropathy. The risk of coeliac disease is increased in first-degree relatives, certain syndromes including Down syndrome and autoimmune disorders. It is thought to occur in 1 in 100–200 individuals, but still only one in four cases is diagnosed. Small-bowel biopsy is no longer deemed necessary in a subgroup of patients, i.e. when all of the following are present: typical symptoms or signs, high titres of and transglutaminase antibodies, endomysial antibodies, and HLA-type DQ2 or DQ8. In all other cases, small-bowel biopsy remains mandatory for a correct diagnosis. Therapy consists of a strictly gluten-free diet. This should result in complete disappearance of symptoms and of serological markers. Adequate follow-up is considered essential. Conclusion: Although small-bowel biopsy may be omitted in a minority of patients, small-bowel biopsy is essential for a correct diagnosis of CD in all other cases. Diagnostic work-up should be completed before treatment with gluten-free diet instituted.
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Metadata
Title
Clinical practice
Coeliac disease
Authors
C. M. Frank Kneepkens
B. Mary E. von Blomberg
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 7/2012
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-012-1714-8

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