Last reviewed: March 2019
Last updated: November  2018

Summary

Definition

History and exam

Key diagnostic factors

  • immunoglobulin (IgA) deficiency
  • diarrhea
  • bloating
  • abdominal pain/discomfort
  • anemia
  • dermatitis herpetiformis

Other diagnostic factors

  • 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

Risk factors

  • family history of celiac disease
  • immunoglobulin A deficiency
  • type 1 diabetes
  • autoimmune thyroid disease
  • Down syndrome
  • Sjogren syndrome
  • inflammatory bowel disease
  • primary biliary cirrhosis

Diagnostic investigations

1st investigations to order

  • CBC and blood smear
  • immunoglobulin A-tissue transglutaminase (IgA-tTG)
  • endomysial antibody (EMA)
  • skin biopsy
  • IgG DGP (deamidated gliadin peptide) or IgA/IgG DGP
  • IgG-tTG
  • small bowel - macroscopic
  • small bowel - histology
Full details

Investigations to consider

  • human leukocyte antigen (HLA) typing
  • gluten challenge
Full details

Emerging tests

  • saliva celiac genetic test
Full details

Treatment algorithm

ONGOING

Contributors

Authors VIEW ALL

Clinical Research Fellow in Celiac Disease

Harvard Medical School

Beth Israel Deaconess Medical Center

Boston

MA

Disclosures

AT declares that she has no competing interests.

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.

Dr Amelie Therrien and Professor Ciaran P. Kelly would like to gratefully acknowledge Dr Daniel A. Leffler, a previous contributor to this topic. DAL declares that he has no competing interests.

Peer reviewers VIEW ALL

Senior Clinical Lecturer and Honorary Consultant Gastroenterologist

Department of Infection, Immunity & Cardiovascular Disease

Sheffield Medical School

Sheffield

UK

Disclosures

MK declares that he has no competing interests.

Professor of Medicine

Rosalind Franklin Medical School

Chicago

IL

Disclosures

EE declares that he has no competing interests.

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