title: The diagnosis and treatment of celiac disease.
abstract: BACKGROUND
  Celiac disease is an inflammatory disease of, the small intestine with a prevalence of roughly 0.5%-1%. Its symptoms arise in response to gluten consumption by genetically predisposed persons (HLA-DQ2/8). The autoantigen tissue transglutaminase (TG2) plays an important role in the pathogenesis of celiac disease.
  
  
  METHODS
  Selective review of pertinent literature, including guidelines from Germany and abroad.
  
  
  RESULTS
  Celiac disease can present at any age with gastrointestinal or extraintestinal manifestations (e.g., malabsorption or Duhring's dermatitis herpetiformis); it can also be found in association with other (auto-)immune diseases, such as type 1 diabetes. Most cases are oligosymptomatic. The wide differential diagnosis includes food intolerances, intestinal infections, and irritable bowel syndrome, among other conditions. The definitive diagnosis requires the demonstration of celiac disease-specific autoantibody to TG2 (endomysium), which is over 90% sensitive and far over 90% specific, and the characteristic histologic lesions of the small-bowel mucosa and remission on a gluten-free diet.
  
  
  CONCLUSIONS
  An understanding of celiac disease ought to inform everyday clinical practice in all medical disciplines, because this is a common condition with diverse manifestations that can be effectively diagnosed and easily treated for the prevention of both acute and long-term complications. Patients should follow a strictly gluten-free diet for life.
authors.affiliation: Institute of Translational Immunology, Johannes Gutenberg University, Mainz, and Division of Gastroenterology, Beth Israel deaconess Medical Center, Harvard Medical School, Boston, MA, USA, Center for Pediatric and Adolescent Medicine, Justus Liebig University, Gießen.
authors.forename: Detlef
authors.initials: D
authors.lastname: Schuppan
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Zimmer
mesh_terms: D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D055050:Diet, Gluten-Free / Q000379:methods* / Q000592:standards*; D019317:Evidence-Based Medicine; D019204:GTP-Binding Proteins; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000097:blood*
chemical_list: D015415:Biomarkers; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins