Novel diagnostic techniques for celiac disease

Abstract

The diagnosis of celiac disease has long been based on the demonstration of gluten-induced small-bowel mucosal damage. However, due to the constantly increasing disease prevalence and limitations in the histology-based criteria there is a pressure towards more serology-based diagnostics. The serological tools are being improved and new non-invasive methods are being developed, but the constantly refined endoscopic and histologic techniques may still prove helpful. Moreover, growing understanding of the disease pathogenesis has led researchers to suggest completely novel approaches to celiac disease diagnostics regardless of disease activity. In this review, we will elucidate the most recent development and possible future innovations in the diagnostic techniques for celiac disease.

Why were Sardinians the shortest Europeans? A journey through genes, infections, nutrition, and sex

“…Children carrying the double defect may have been at risk of developing very short stature (Freemark & Levitsky, ). However, in the past decades early detection of coeliac disease due to improved noninvasive diagnostic tools (Kurppa, Taavela, Saavalainen, Kaukinen, & Lindfors, ) has led to the prompt introduction of a gluten‐free diet able to prevent adverse long‐term outcomes of the disease, such as shorter stature in adulthood.…”

Diagnóstico diferencial entre doença celíaca e sensibilidade ao glúten não-celíaca: uma revisão

“…14,17 Classificação da DC Durante décadas, o diagnóstico da DC baseouse na biópsia intestinal e demonstração de lesões típicas da mucosa, como hiperplasia de criptas e atrofia de vilosidades, em pacientes com quadro clínico e sorológico compatível. 20,21 A combinação de informações sorológicas, histológicas e genéticas levou à identificação de diferentes manifestações da DC, abaixo classificadas. 3,12 DC assintomática: pacientes que habitualmente recebem o diagnóstico através de screening populacional ou testes por outros motivos.…”

“…Apesar de os testes atuais serem habitualmente adequados e suficientes para o diagnóstico de DC, há pacientes com resultados equívocos mesmo após extensa investigação, de maneira que novos exames diagnósticos têm sido avaliados. 20,31 Técnicas endoscópicas recentes que aumentam o rendimento diagnóstico de biópsias incluem: 43,44 -Imersão em água: aspiração de ar e injeção de 100-150 mililitros de água dentro do duodeno; -Endomicroscopia confocal: um microscópio a laser integrado na ponta do endoscópio permite a avaliação simultânea da macro e microscopia da mucosa;…”

Novel Insights to Celiac Disease: A review article

“…An alteration of performance symptoms from gastrointestinal (still called typical) to extra intestinal (atypical) has been observed in many geographic regions during the past decades and looks to be a common trend, along with a larger part of patients recognized as having potential CD and a move toward older ages at appearance. At first thought only children are affected by demonstrating diarrhea and presenting a malabsorptive picture (3,9,12,13,38,28) CD was later verified to affect adults as well, happening at any age. Table 2 reviews the main symptoms of CD performance in its gastrointestinal and extra intestinal or atypical forms (3,12,14,30).…”

“…The lesion is usually scored by grouped classification. But this grouping has manifested weak reproducibility, particularly in borderline cases (36)(37)(38) and interpretation of samples may differ considerably among pathologists (37). One more exact method is advance morphometry in which the proportion of villous height-crypt depth and intraepithelial lymphocyte count are measured separately.…”