Summary
Definition
History and exam
Key diagnostic factors
- diarreia
- distensão abdominal
- dor/desconforto abdominal
- anemia
- Deficiência de imunoglobulina (IgA)
- dermatite herpetiforme
Other diagnostic factors
- história familiar
- osteopenia/osteoporose
- fadiga
- perda de peso
- retardo do crescimento pôndero-estatural
- diabetes do tipo 1
- doença tireoidiana autoimune
- estomatite aftosa
- hipoplasia do esmalte dental
- hematomas frequentes
- neuropatia periférica
- ataxia
- elevação inexplicada dos níveis de aminotransferase sérica
- diagnóstico de comorbidade psiquiátrica
Risk factors
- história familiar de doença celíaca
- deficiência de imunoglobulina A
- diabetes do tipo 1
- doença tireoidiana autoimune
- Síndrome de Down
- Síndrome de Turner
- Síndrome de Sjögren
- doença inflamatória intestinal
- colangite biliar primária
- psoríase
Diagnostic tests
1st tests to order
- imunoglobulina A-transglutaminase tecidual (IgA-tTG)
- IgA quantitativa
- IgG peptídeo de gliadina desamidada (DGP)
- Hemograma completo
- anticorpo antiendomísio (EMA)
- biópsia de pele
- endoscopia do intestino delgado
- histologia do intestino delgado
Tests to consider
- tipagem do antígeno leucocitário humano (HLA)
- teste de provocação com glúten
- videoendoscopia por cápsula
Treatment algorithm
doença celíaca
falha ao responder à terapia/doença celíaca refratária
crise celíaca
Contributors
Authors
Amelie Therrien, MD
Gastroenterologist, Celiac Center
Instructor in Medicine, Harvard Medical School
Beth Israel Deaconess Medical Center
Boston
MA
Disclosures
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
Disclosures
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.
Acknowledgements
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.
Disclosures
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.
Peer reviewers
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
Disclosures
MK declares that he has no competing interests.
Eli D. Ehrenpreis, MD
Professor of Medicine
Rosalind Franklin Medical School
Chicago
IL
Disclosures
EDE declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
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.Full text Abstract
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.Full text Abstract
Chaudrey KH. ACG guideline: diagnosis and management of celiac disease. Am J Gastroenterol. 2023;118(1):23. Abstract
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.Full text Abstract
National Institute for Health and Care Excellence. Coeliac disease: recognition, assessment and management. Sep 2015 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Duodenite péptica
- Doença de Crohn
- Giardíase
More DifferentialsGuidelines
- Diagnosis and management of celiac disease
- Coeliac disease: recognition, assessment and management
More GuidelinesPatient information
Doença celíaca
More Patient information
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