Coeliac disease

• Autores: Jeremy Woodward
• Localización: Medicine, ISSN-e 1357-3039, Vol. 43, Nº. 4, 2015, págs. 234-238
• Idioma: inglés
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• Resumen

  • Coeliac disease is a common condition that affects up to 1% of Caucasian and North West Asian populations. It may present at any age after weaning with a spectrum of symptoms ranging from none, through mild irritable bowel type complaints, to weight loss and diarrhoea. Coeliac disease is often associated with other autoimmune conditions. The majority of patients express either HLA DQ2 or DQ8 haplotypes, but many other genes (some of which have recently been identified) are implicated in disease susceptibility. IgA antibodies against tissue transglutaminase show a high specificity but a sensitivity that may be as low as 90% for detection of the condition. Intestinal biopsy remains the diagnostic standard. Treatment with a strict gluten-free diet is mandatory and leads to a reduced risk of associated complications that include low bone mineral density and intestinal malignancy. Most patients thought to be ‘refractory’ to dietary treatment are found to have gluten sources in the diet, but a small proportion harbour atypical monoclonal intraepithelial lymphocytes and are at risk of developing intestinal lymphoma. Non-dietary treatments are currently under investigation.