title: Celiac disease: diagnosis and treatment.
abstract: This national clinical guideline approved by the Danish Society for Gastroenterology and Hepatology describes the diagnosis and treatment of celiac disease (CD) in adults. CD is a chronic immune-mediated enteropathy of the small intestine triggered by the ingestion of gluten-containing proteins, which are found in wheat, rye, and barley. The disease prevalence is 0.5-1.0%, but CD remains under-diagnosed. The diagnosis relies on the demonstration of lymphocyte infiltration, crypt hyperplasia, and villous atrophy in duodenal biopsies. Serology, malabsorption, biochemical markers, and identification of specific HLA haplotypes may contribute to CD diagnosis. Classical CD presents with diarrhoea and weight loss, but non-classical CD with vague or extraintestinal symptoms is common. The treatment for CD is a lifelong gluten-free diet (GFD), which, in the majority of patients, normalises the small intestinal mucosa and absorption. Adherence to a GFD usually requires dietary advice from a clinical dietician. The monitoring of antibody levels and malabsorption markers is crucial during follow-up and allows for early treatment of disease complications. Important complications include osteoporosis, iron and vitamin deficiencies, and enteropathy-associated T-cell lymphoma.
authors: Christian Lodberg
authors: CL
authors: Hvas
authors: Michael Dam
authors: MD
authors: Jensen
authors: Maria Christina
authors: MC
authors: Reimer
authors: Lene Buhl
authors: LB
authors: Riis
authors: Jüri Johannes
authors: JJ
authors: Rumessen
authors: Hanne
authors: H
authors: Skovbjerg
authors: Ane
authors: A
authors: Teisner
authors: Department of Medicine, Køge Sygehus, Lykkebækvej 1, 4600 Køge, Denmark. siwi@regionsjaelland.dk.
authors: Signe
authors: S
authors: Wildt
mesh_terms: D001707:Biopsy, Needle; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy*; D003718:Denmark; D055050:Diet, Gluten-Free; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome