Is this really celiac disease? Pitfalls in diagnosis.
Celiac disease (CD) is an autoimmune enteropathy triggered in susceptible individuals by ingestion of gliadin-containing grains. Although the autoimmune process targets mainly the intestinal mucosa, CD can manifest itself with a variety signs and symptoms affecting any organ or tissue. For many years, CD has been underdiagnosed because of poor awareness. However, studies showing a high prevalence of CD in North America, followed by a consensus conference on CD organized by the National Institutes of Health, have fueled a campaign to raise awareness among subspecialists and primary physicians. Nevertheless, guidelines for the diagnosis of CD remain poorly appreciated and many health care professionals remain confused about its proper management. This review is intended to clarify "facts and fantasies" about CD diagnosis.
Catassi
Carlo
C
University of Maryland School of Medicine, Mucosal Biology Research Center and Center for Celiac Research, Health Science Facility II, Baltimore, MD 21201, USA.
Fasano
Alessio
A
D002446:Celiac Disease / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans
Gut. 2007 Oct;56(10):1339-40
17872565
Arch Intern Med. 2005 Feb 28;165(4):393-9
15738367
Arch Intern Med. 2003 Feb 10;163(3):286-92
12578508
Am J Gastroenterol. 2001 Jan;96(1):126-31
11197241
Gastroenterology. 2001 Feb;120(3):636-51
11179241
Neurol Sci. 2003 Dec;24(5):311-7
14716525
Gut. 1993 Feb;34(2):150-1
8432463
Am J Clin Nutr. 1998 Mar;67(3):477-81
9497193
J Pediatr Gastroenterol Nutr. 2005 Jan;40(1):1-19
15625418
Arq Neuropsiquiatr. 2003 Jun;61(2B):330-4
12894262
J Pediatr. 1983 Nov;103(5):708-11
6631596
J Pediatr Endocrinol Metab. 2003 Jul-Aug;16(6):805-18
12948292
Neurology. 2003 May 27;60(10):1581-5
12771245
Am J Gastroenterol. 1992 May;87(5):580-3
1595643
Best Pract Res Clin Gastroenterol. 2005 Jun;19(3):341-50
15925840
Am J Gastroenterol. 2008 Jan;103(1):190-5
18184122
Acta Paediatr. 1995 Nov;84(11):1252-7
8580621
Aliment Pharmacol Ther. 2006 Aug 1;24(3):541-52
16886921
Gastroenterology. 2005 Apr;128(4 Suppl 1):S38-46
15825125
Pediatrics. 1998 Feb;101(2):272-5
9445503
Am J Gastroenterol. 2007 Jul;102(7):1454-60
17355413
Clin Gastroenterol Hepatol. 2005 Sep;3(9):843-51
16234020
J Pediatr Gastroenterol Nutr. 2007 Oct;45(4):497-9
18030224
Gastroenterology. 2006 Dec;131(6):1981-2002
17087937
Diabetes Metab Res Rev. 1999 Jul-Aug;15(4):254-60
10495474
Eur J Gastroenterol Hepatol. 1999 Oct;11(10):1185-94
10524652
J Gen Intern Med. 2005 Jul;20(7):644-6
16050861
Endoscopy. 2008 Mar;40(3):219-24
18058655
Med Decis Making. 2006 May-Jun;26(3):282-93
16751327
J Pediatr. 2005 Apr;146(4):494-9
15812452
J Pediatr Gastroenterol Nutr. 2001 Oct;33(4):483-7
11698768
Lancet. 1998 Nov 14;352(9140):1582-5
9843103
J Gastroenterol Hepatol. 2006 Oct;21(10):1511-3
16928209
Am J Gastroenterol. 2005 Jan;100(1):177-85
15654798
N Engl J Med. 2003 Jun 19;348(25):2568-70
12815143
J Clin Pathol. 2005 Jun;58(6):573-4
15917404
Braz J Med Biol Res. 2004 Jan;37(1):55-60
14689044
J Pediatr Gastroenterol Nutr. 2004 Feb;38(2):204-7
14734885
Scand J Gastroenterol. 1982 Jan;17(1):65-8
7134839
Clin Exp Immunol. 2007 Nov;150(2):285-93
17803713
Scand J Gastroenterol. 2005 May;40(5):564-72
16036509
Dig Dis Sci. 2007 Apr;52(4):1087-95
17318390