Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • IgA deficiency
  • diarrhoea
  • bloating
  • abdominal pain/discomfort
  • anaemia
  • dermatitis herpetiformis

Other diagnostic factors

  • FHx
  • osteopenia/osteoporosis
  • fatigue
  • weight loss
  • failure to thrive
  • type 1 diabetes
  • autoimmune thyroid disease
  • aphthous stomatitis
  • dental enamel hypoplasia
  • alopecia
  • easy bruising
  • peripheral neuropathy
  • ataxia

Risk factors

  • FHx of coeliac disease
  • IgA deficiency
  • type 1 diabetes
  • autoimmune thyroid disease
  • Down's syndrome
  • Sjogren's syndrome
  • inflammatory bowel disease
  • primary biliary cirrhosis

Diagnostic investigations

1st investigations to order

  • FBC and blood smear
  • IgA-tTG
  • EMA
  • skin bx
  • IgG DGP or IgA/IgG DGP (deamidated gliadin peptide)
  • IgG-tTG
Full details

Investigations to consider

  • HLA typing
  • small bowel - macroscopic
  • small bowel - histology
  • gluten challenge
Full details

Emerging tests

  • point-of-care tTG testing
  • saliva coeliac genetic test
Full details

Treatment algorithm

ONGOING

Contributors

Authors VIEW ALL

Ciaran P. Kelly

Professor of Medicine

Harvard Medical School

Beth Israel Deaconess Medical Center

Boston

MA

Disclosures

CPK declares that he has no competing interests.

Daniel A. Leffler

Associate Professor of Medicine

Harvard Medical School

Beth Israel Deaconess Medical Center

Boston

MA

Disclosures

DAL declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Gastroenterologist

Connolly Hospital and Royal College of Surgeons in Ireland

Dublin

Ireland

Disclosures

RF declares that he has no competing interests.

Professor of Pediatrics, Medicine, and Physiology

Director of Mucosal Biology Research Center

University of Maryland School of Medicine

Baltimore

MD

Disclosures

AF has financial interests in Alba Therapeutics, a company that is developing treatments for celiac disease as alternatives to the gluten-free diet.

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