Who to screen and how to screen for celiac disease  

作　　者：Prashant Singh Achintya Dinesh Singh Vineet Ahuja Govind K Makharia 

机构地区：[1]Department of Gastroenterology,University of Michigan,Ann Arbor,MI 48109,United States [2]Department of Medicine,Cleveland Clinic,Cleveland,OH 44195,United States [3]Department of Gastroenterology and Human Nutrition,All India Institute of Medical Sciences,New Delhi 110029,India

出　　处：《World Journal of Gastroenterology》2022年第32期4493-4507,共15页世界胃肠病学杂志（英文版）

基　　金：support of Department of Biotechnology,Government of India,for creation of Indian Consortium on Celiac Disease and National Celiac Disease Biorepository;support from Research Section of our institution for facilitating the research on Celiac disease.

摘　　要：Celiac disease(CeD)is a chronic gluten-induced enteropathy with plethoric manifestations.The typical manifestations of CeD such as chronic diarrhea and malabsorption are widely recognized,however,many patients have atypical manifestations like iron deficiency anemia,idiopathic short stature,hypertransaminesemia or infertility,etc.These patients often present to the primary care physicians and/or non-gastrointestinal specialties.However,due to a lack of awareness among the healthcare professionals about the various atypical manifestations,many patients are not screened for CeD.In this review,we have summarized the available literature about the prevalence of CeD in various gastrointestinal(chronic diarrhea)and non-gastrointestinal conditions(iron deficiency anemia,short stature,cryptogenic hypertransaminesemia,cryptogenic cirrhosis or idiopathic ataxia etc.)where the diagnosis of CeD should be considered.In addition,we also discuss special scenarios where screening for CeD should be considered even in absence of symptoms such as patients with type 1 diabetes,Down’s syndrome,and first-degree relatives of patients with CeD.Further,we discuss the diagnostic performance and limitations of various screening tests for CeD such as IgA anti-tissue transglutaminase antibodies,antiendomysial antibodies and anti-deamidated gliadin antibodies.Based on the current recommendations,we propose a diagnostic algorithm for patients with suspected CeD.

关 键 词：SCREENING DIAGNOSIS SEROLOGY High-risk group Small intestine ENTEROPATHY 

分 类 号：R574.62[医药卫生—消化系统]