Diagnostic Challenges in Celiac Disease
author
Abstract:
1. The most important challenge in diagnosis of celiac disease is not-performing the diagnostic tests in suspected persons. Because of multi-organ damage and multiple manifestations of disease, diagnosis of celiac disease may be delayed. It seems general physicians should be aware about uncommon presentations of disease and indications of celiac tests. 2. The second most important challenge is in patients with suspected disease but negative serologic tests. In these cases evaluating of HLA can be useful. 3. The third challenge is in cases with positive serologic tests but negative histopathological findings. There may be false positive serologic response or consumption of gluten before testing. We recommend introduction of gluten for at least 3 mo and re- endoscopy and if diagnosis is equivocal HLA-typing for DQ8 and DQ2 should be done. 4. The forth challenge is about performing endoscopy. Based on guideline from ESPGHAN if there are typical clinical manifestations of celiac disease, Anti-TTG more than ten times UPN, positive Anti-EMA and HLA DQ2, performing endoscopy may not be necessary, but many physicians don’t agree with this idea. 5. In people who are genetically predisposed to celiac disease antibody levels may be fluctuating thus endoscopy with biopsy should be done in these patients. 6. In children lower than 2years, Anti- TTG and Anti –EMA have low sensitivity. we recommend Anti-TTG and Anti-DGP in these patients. 7. Resolution of symptoms after gluten free diet is not necessarily a feature of celiac disease. This condition may be seen in patients with IBS or non-celiac gluten sensitivity.
similar resources
Diagnostic challenges in celiac disease
1-The most important challenge in diagnosis of celiac disease is not- performing the diagnostic tests in suspected persons. Because of multi-organ damage and multiple manifestations of disease, diagnosis of celiac disease may be delayed. It seems general physicians should be awared about uncommon presentations of disease and indications of celiac tests 2-The second most important challenge is...
full textdiagnostic challenges in celiac disease
1. the most important challenge in diagnosis of celiac disease is not-performing the diagnostic tests in suspected persons. because of multi-organ damage and multiple manifestations of disease, diagnosis of celiac disease may be delayed. it seems general physicians should be aware about uncommon presentations of disease and indications of celiac tests. 2. the second most important challenge is ...
full textCeliac disease in Pakistan: challenges and opportunities.
Celiac disease is a permanent intolerance to gluten (a protein present in wheat, rye and barley), which causes damage to the small intestinal mucosa by an autoimmune mechanism in genetically susceptible individuals. The villous atrophy that ensues can lead to malabsorption of a variety of macro and micronutrients including iron, calcium, folate and fat soluble vitamins. 1 Celiac disease was tho...
full textDiagnostic Challenges in AIH
Autoimmune hepatitis is a chronic hepatitis that occurs in children and adults of all ages. Diagnosis is based upon characteristic serologic and histologic findings and the exclusion of other forms of chronic liver disease. Guidelines issued by the AASLD suggest the following diagnostic considerations: The diagnosis should be made in patients with compatible clinical signs, symptoms, and labora...
full textCeliac Disease: Diagnostic Standards and Dilemmas
Celiac Disease (CD) affects at least 1% of the population and evidence suggests that prevalence is increasing. The diagnosis of CD depends on providers being alert to both typical and atypical presentations and those situations in which patients are at high risk for the disease. Because of variable presentation, physicians need to have a low threshold for celiac testing. Robust knowledge of the...
full textMy Resources
Journal title
volume 2 issue 2.2
pages 111- 111
publication date 2014-04-01
By following a journal you will be notified via email when a new issue of this journal is published.
Keywords
Hosted on Doprax cloud platform doprax.com
copyright © 2015-2023