Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- diarrhea
- bloating
- abdominal pain/discomfort
- anemia
- immunoglobulin (IgA) deficiency
- dermatitis herpetiformis
Otros factores de diagnóstico
- family history
- osteopenia/osteoporosis
- fatigue
- weight loss
- failure to thrive
- type 1 diabetes
- autoimmune thyroid disease
- aphthous stomatitis
- dental enamel hypoplasia
- easy bruising
- peripheral neuropathy
- ataxia
- unexplained elevation of serum aminotransferase levels
- comorbid psychiatric diagnosis
Factores de riesgo
- family history of celiac disease
- immunoglobulin A deficiency
- type 1 diabetes
- autoimmune thyroid disease
- Down syndrome
- Turner syndrome
- Sjogren syndrome
- inflammatory bowel disease
- primary biliary cholangitis
- psoriasis
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- immunoglobulin A-tissue transglutaminase (IgA-tTG)
- quantitative IgA
- IgG DGP (deamidated gliadin peptide)
- CBC
- endomysial antibody (EMA)
- skin biopsy
- small bowel endoscopy
- small bowel histology
Pruebas diagnósticas que deben considerarse
- human leukocyte antigen (HLA) typing
- gluten challenge
- video capsule endoscopy
- immunoglobulin G-tissue transglutaminase (IgG-tTG)
Algoritmo de tratamiento
celiac disease
failure to respond to therapy/refractory celiac disease
celiac crisis
Colaboradores
Autores
Amelie Therrien, MD
Gastroenterologist, Celiac Center
Instructor in Medicine, Harvard Medical School
Beth Israel Deaconess Medical Center
Boston
MA
Divulgaciones
AT is a site principal investigator for National Institute of Allergy and Infectious Diseases NIAID (IMX003 [latiglutenase]).
Benjamin Lebwohl, MD, MS
Associate Professor of Medicine and Epidemiology
Columbia University Irving Medical Center
New York
NY
Divulgaciones
BL is an unpaid advisor for Nima Partners, Takeda, Teva, 9 Meters Biopharma, Bristol Myers Squibb, Mozart Therapeutics, and Alimentiv and a contractual researcher for Anokion. BL is an author of several references in this topic.
Agradecimientos
Dr Amelie Therrien and Dr Benjamin Lebwohl would like to gratefully acknowledge Professor Ciaran P. Kelly and Dr Daniel A. Leffler, previous contributors to this topic.
Divulgaciones
DAL declares that he has no competing interests. CPK is a scientific advisor/consultant for Cour Pharma, Glutenostics, Immunogenx, Innovate, and Takeda Pharmaceuticals. He is an investigator for Aptalis and Takeda, and has stock options in Cour Pharma and Glutenostics. CPK is also a co-author of several references cited in this topic.
Revisores por pares
Matthew Kurien, PGDip MedSci, MD, MBChB, MRCP
Senior Clinical Lecturer and Honorary Consultant Gastroenterologist
Department of Infection, Immunity & Cardiovascular Disease
Sheffield Medical School
Sheffield
UK
Divulgaciones
MK declares that he has no competing interests.
Eli D. Ehrenpreis, MD
Professor of Medicine
Rosalind Franklin Medical School
Chicago
IL
Divulgaciones
EDE declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019 Jun;7(5):583-613.Texto completo Resumen
van der Windt DA, Jellema P, Mulder CJ, et al. Diagnostic testing for celiac disease among patients with abdominal symptoms: a systematic review. JAMA. 2010 May 5;303(17):1738-46.Texto completo Resumen
Chaudrey KH. ACG guideline: diagnosis and management of celiac disease. Am J Gastroenterol. 2023;118(1):23. Resumen
Husby S, Koletzko S, Korponay-Szabó I, et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for diagnosing coeliac disease 2020. J Pediatr Gastroenterol Nutr. 2020 Jan;70(1):141-56.Texto completo Resumen
National Institute for Health and Care Excellence. Coeliac disease: recognition, assessment and management. Sep 2015 [internet publication].Texto completo
Academy of Nutrition and Dietetics (American Dietetic Association). Celiac disease evidence-based nutrition practice guideline. 2021 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
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Más DiferencialesGuías de práctica clínica
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Más Guías de práctica clínicaFolletos para el paciente
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