title: [How and why is the diagnostic approach to celiac disease changing].
abstract: The first classic description of celiac disease (CD) was published in 1888. The introduction in the clinical practice of the jejunal biopsy, in 1957, offered a powerful tool for a more objective approach to the disease. The correct diagnostic procedure for CD was finally established by a document of the European Society for Pediatric Gastro-enterology and Nutrition (ESPGAN) in 1970, and the ESPGAN suggestions were rapidly adopted by the scientific community. During these years, alternative and non-invasive diagnostic approaches were developed such as non-immunological (tests of intestinal absorption and permeability) and immunological (anti-reticulin, anti-endomysium and anti-gliadin antibodies, HLA antigens) tests. Due to the increased reliability of some of these laboratory investigations and to the increased knowledge about CD, it has been recently proposed that a simplification of the usual ESPGAN protocol should be eventually adopted in well defined subjects suspected to have CD.
authors.affiliation: Servizio Pediatrico Speciale, Ospedale Civile Maggiore, Verona, Italia.
authors.forename: E A
authors.initials: EA
authors.lastname: Valletta
mesh_terms: D000328:Adult; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D005983:Glutens; D006801:Humans; D007159:Immunologic Tests; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000473:pathology; D007501:Iron; D007583:Jejunum / Q000473:pathology; D014280:Triglycerides; D014994:Xylose
chemical_list: D014280:Triglycerides; D005983:Glutens; D014994:Xylose; D007501:Iron
vernacular_title: Come e perchè sta cambiando l'approccio diagnostico alla malattia celiaca.