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Last reviewed: 18 Aug 2025
Last updated: 05 Mar 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • diarreia
  • distensão abdominal
  • dor/desconforto abdominal
  • anemia
  • Deficiência de imunoglobulina (IgA)
  • dermatite herpetiforme

Другие диагностические факторы

  • 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

Факторы риска

  • 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

Диагностические исследования

Исследования, которые показаны в первую очередь

  • 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

Исследования, проведение которых нужно рассмотреть

  • tipagem do antígeno leucocitário humano (HLA)
  • teste de provocação com glúten
  • videoendoscopia por cápsula

Алгоритм лечения

Составители

Авторы

Amelie Therrien, MD

Gastroenterologist, Celiac Center

Instructor in Medicine, Harvard Medical School

Beth Israel Deaconess Medical Center

Boston

MA

Раскрытие информации

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

Раскрытие информации

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.

Выражение благодарностей

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.

Раскрытие информации

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.

Рецензенты

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

Раскрытие информации

MK declares that he has no competing interests.

Eli D. Ehrenpreis, MD

Professor of Medicine

Rosalind Franklin Medical School

Chicago

IL

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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.Полный текст  Аннотация

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.Полный текст  Аннотация

Chaudrey KH. ACG guideline: diagnosis and management of celiac disease. Am J Gastroenterol. 2023;118(1):23. Аннотация

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.Полный текст  Аннотация

National Institute for Health and Care Excellence. Coeliac disease: recognition, assessment and management. Sep 2015 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available here.

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