Celiac disease (CD)

Celiac disease: Symptoms
Celiac disease can manifest at any age and present with a variety of symptoms that can affect both the gastrointestinal tract and other organ systems. Typical gastrointestinal symptoms include diarrhea, bloating, abdominal pain, and weight loss. However, extraintestinal symptoms such as iron deficiency, fatigue, skin changes, and neurological abnormalities are also possible. A notable feature of gluten intolerance is that it may present without any symptoms, especially in adults or older people. An important consideration in diagnosing celiac disease is that There is no clinical presentation that can rule out celiac disease with certainty. Even in the presence of symptoms such as obesity or chronic constipation, which are not classically associated with the disease, celiac disease should be considered-especially if there is a family history or accompanying autoimmune diseases.
Clinical picture of celiac disease
| Form | Clinical | Celiac disease Antibodies | Genetics HLA | Histology |
|---|---|---|---|---|
| Classic | Signs of malabsorption | Positive | DQ2 / DQ8 | Marsh 2 or 3 |
| Symptomatic | Non-specific gastrointestinal or extraintestinal symptoms | Positive | DQ2 DQ2 / | Marsh 2 or 3 |
| Subclinical | No clinical symptoms, but noticeable laboratory values or clinical improvement on diet | Positive | DQ8/ DQ8 | Marsh 2 or 3 |
| Potential | No or few specific symptoms | Positive | DQ8/ DQ8 | Marsh 0 or 1 |
| Refractory | Signs of malabsorption and villous atrophy despite a gluten-free diet for over 12 months | Positive at initial diagnosis, course of the disease negative or positive | DQ8/ DQ8 | Marsh 3 |
Table: Forms of celiac disease (Oslo classification) according to S2k guideline
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Read moreSources
- Felber, J., Bläker, H., Fischbach, W., Koletzko, S., Laaß, M.W., Lachmann, N., Lorenz, P., Lynen, P., Reese, I., Scherf, K., Schuppan, D., & Schumann, M. (2021). Updated S2k guideline on celiac disease from the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS). Consultation version October 2021
- Verdelho Machado M. Refractory Celiac Disease: What the Gastroenterologist Should Know. Int J Mol Sci. 2024 Sep 26;25(19):10383. doi: 10.3390/ijms251910383. PMID: 39408713; PMCID: PMC11477276.
