Society for the Study of Celiac Disease position statement on gaps and opportunities in coeliac disease

Abstract

Progress has been made in understanding coeliac disease, a relatively frequent and underappreciated immune-mediated condition that occurs in genetically predisposed individuals. However, several gaps remain in knowledge related to diagnosis and management. The gluten-free diet, currently the only available management, is not curative or universally effective (some adherent patients have ongoing duodenal injury). Unprecedented numbers of emerging therapies, including some with novel tolerogenic mechanisms, are currently being investigated in clinical trials. In March 2020, the Celiac Disease Foundation and the Society for the Study of Celiac Disease convened a consensus workshop to identify high-yield areas of research that should be prioritized. Workshop participants included leading experts in clinical practice, academia, government and pharmaceutical development, as well as representatives from patient support groups in North America. This Roadmap summarizes key advances in the field of coeliac disease and provides information on important discussions from the consensus approach to address gaps and opportunities related to the pathogenesis, diagnosis and management of coeliac disease. The morbidity of coeliac disease is often underestimated, which has led to an unmet need to improve the management of these patients. Expanded research funding is needed as coeliac disease is a potentially curable disease.

Atrioventricular Block in Celiac Disease: An Unusual Clinical Presentation in a Child. A Case-Based Review

“…The estimated global prevalence of CeD is approximately 1%. CeD occurs at any age from early childhood to an adult age, with a first peak after gluten intake within the first 2 years of life and the second one in the second or third decade of life [ 4 , 5 , 6 , 7 ].…”

“…The typical clinical presentation of CeD is characterized by intestinal manifestations such as diarrhea, a loss of appetite, abdominal distention, bloating, constipation, abdominal pain, and weight loss. Sometimes there are extra-intestinal symptoms: the most common ones are anemia, osteoporosis, fatigue, aphthous stomatitis, headache, and reproductive disorders [ 4 , 5 , 6 , 7 ]. The prevalence of extra-intestinal manifestations of CeD is similar between the pediatric patients and adults (approximately 60%), however the specific manifestations of it are different; the most common extra-intestinal CeD manifestations are a short stature in the pediatric population and iron deficiency anemia in adults [ 2 , 5 , 6 , 7 ].…”

Personalised Nutritional Plan and Resistance Exercise Program to Improve Health Parameters in Celiac Women

“…Gluten intolerance is a systemic alteration in the immune system that can develop at various stages of the life cycle in response to gluten ingestion in genetically predisposed individuals [ 1 , 2 ]. Celiac disease (CD) is defined as a type of chronic, permanent intolerance to the gluten protein.…”

“…The sensitivity of upper endoscopy is close to 60% and the specificity is 95–100% [ 4 , 5 ]. It has been reported that the measurement of anti-tissue transglutaminase IgA and the total level of immunoglobulin A (IgA) in serum is the most cost-effective and accurate means of serological testing for CD [ 2 ]. This serological test is highly specific, sensitive, and less expensive than serum anti-endomysial antibody dosing.…”

Pancreatic involvement in celiac disease

“…The systemic character along with its various clinical presentations make CD a sometimes difficult to recognize clinical chameleon. The wide spectrum of presenting features, sometimes subclinical, hinders case-finding strategies and delays diagnosis, as CD is often not considered among the differential diagnoses[ 1 , 2 ]. Moreover, there is also the further drawback of poor awareness among different medical specialties[ 3 ].…”