Skip to main content

Celiac disease

Abstract

Purpose of review

The aim of this review was to summarize recent advances in celiac disease (CD) published between 2006 and 2012.

Recent findings

CD affects ~ 1% of most populations but remains largely unrecognized. During the past year, research has shown that the prevalence of CD has increased dramatically and not merely because of increased detection. Moreover, undiagnosed CD may be associated with increased mortality. Significant progress has been made in understanding how gliadin peptides can cross the intestinal border and access the immune system. New deamidated gliadin peptide antibodies have better diagnostic accuracy over other tests. The inclusion of duodenal bulb biopsy specimens may increase the rate of CD detection. Finally, refractory CD, although rare, is associated with a poor prognosis. The use of novel highly efficient exogenous prolyl endoproteases enzymes may help patients deal with occasional lapses in their diet or may protect highly sensitive individuals from inadvertent presence of gluten in food products. Nevertheless, the efficiency of this approach still needs precise assessment.

Conclusion

Mortality rates among patients with untreated CD increase two-fold every year as they age (gastrointestinal malignancies) and most can be prevented/reversed with early diagnosis and initiation of a gluten-free diet. CD is a global health problem that requires a multidisciplinary and increasingly cooperative multinational research effort.

References

  1. Husby S, Koletzko S, Korponay Szabó IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54:136–160.

    Article  CAS  Google Scholar 

  2. Gibson CM. Celiac disease historical perspective. 2012. Available at: http://ja.wikidoc.org/index.php/Celiac_disease_historical_perspective [Accessed 31 August 2012].

  3. Walker MM, Murray JA. An update in the diagnosis of coeliac disease. Histopathology 2011; 59:166–179.

    PubMed  Google Scholar 

  4. Abu Zekry M, Kryszak D, Diab M, Catassi C, Fasano A. Prevalence of celiac disease in Egyptian children disputes the east west agriculture-dependent spread of the disease. J Pediatr Gastroenterol Nutr 2008; 47:136–140.

    Article  CAS  Google Scholar 

  5. Tack GJ, Verbeek WHM, Schreurs MWJ, CJJ Mulder. The spectrum of celiac disease: epidemiology, clinical aspects and treatment. Nat Rev Gastro-enterol Hepatol 2010; 7:204–213.

    Article  CAS  Google Scholar 

  6. Pozo Rubio T, Olivares M, Nova E, De Palma G, Mujico JR, Ferrer MD, et al. Immune development and intestinal microbiota in celiac disease. Clin Dev Immunol 2012; 2012:654143.

    Article  Google Scholar 

  7. Lebenthal E, Shteyer E, Branski D. The changing clinical presentation of celiac disease. In: Fasano A, Troncone R, Branski D, editors. Frontiers in celiac disease. Karger: Basel; 2008. pp. 18–22.

    Chapter  Google Scholar 

  8. Stene LC, Honeyman MC, Hoffenberg EJ, Haas JE, Sokol RJ, Emery L, et al. Rotavirus infection frequency and risk of celiac disease autoimmunity in early childhood: a longitudinal study. Am J Gastroenterol 2006; 101: 2333–2340.

    Article  CAS  Google Scholar 

  9. Long KH, Rubio Tapia A, Wagie AE, Melton Iii LJ, Lahr BD, Van Dyke CT, et al. The economics of coeliac disease: a population-based study. Aliment Pharmacol Ther 2010; 32:261–269.

    Article  CAS  Google Scholar 

  10. Catassi C, Yachha SK. The global village of celiac disease. In: Fasano A, Troncone R, Branski D, editors. Frontiers in celiac disease. Karger: Basel; 2008. pp. 23–31.

    Chapter  Google Scholar 

  11. Meresse B, Ripoche J, Heyman M, Cerf Bensussan N. Celiac disease: from oral tolerance to intestinal inflammation, autoimmunity and lymphomagenesis. Mucosal Immunol 2009; 2:8–23.

    Article  CAS  Google Scholar 

  12. Kaukinen K, Collin P, Mäki M. Natural history of celiac disease. In: Fasano A, Troncone R, Branski D, editors. Frontiers in celiac disease. Karger: Basel; 2008. pp. 23–31.

    Google Scholar 

  13. Raymond N, Heap J, Case S. The gluten free diet, an update for health professionals in the celiac diet, series #1. 2006. Available at: http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-health/nutrition-support-team/nutrition-articles/Sept0601.pdf [Accessed February 2013].

  14. Karger S. Practical algorithms in pediatric nephrology. In: Zelikovic I, Eisenstein I, editors. Basell, Switzerland: 2008. Available at: http://www.karger.com.

  15. Rubio Tapia A, Kelly DG, Lahr BD, Dogan A, Wu T, Murray JA. Clinical staging and survival in refractory celiac disease: a single center experience. Gastroenterology 2009; 136:99–107.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dina I. Shehab.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shehab, D.I. Celiac disease. Egypt J Intern Med 25, 53–62 (2013). https://doi.org/10.7123/01.EJIM.0000429397.19027.b6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.7123/01.EJIM.0000429397.19027.b6

Keywords