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Clin Chem Lab Med. 2010 Sep;48(9):1205-16. doi: 10.1515/CCLM.2010.241.

Coeliac disease--a diagnostic and therapeutic challenge.

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1
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. katri.kaukinen@uta.fi

Abstract

During the past 20 years the diagnosis of coeliac disease has improved significantly. However, at the same time the true prevalence of the condition has doubled, involving more than 2% of the population in some countries. Due to mild or atypical symptoms, the diagnosis remains a challenge for the health care system. Highly sensitive and specific serum endomysial and transglutaminase-2 antibody tests are helpful in identifying patients for diagnostic endoscopy and small-bowel biopsy. The diagnosis of the disease is still based on the demonstration of gluten-induced small-bowel mucosal villous atrophy with crypt hyperplasia. However, coeliac disease may manifest itself before the development of the overt small-intestinal lesion. Positive endomysial and transglutaminase antibodies in patients with normal small-bowel mucosal villous architecture may indicate early stage coeliac disease. Currently, the only effective treatment for the condition is a life-long strict gluten-free diet. Long-term regular follow-up of patients is recommended in order to maintain good adherence to the diet.

PMID:
20578966
DOI:
10.1515/CCLM.2010.241
[Indexed for MEDLINE]
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