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European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders.
United European Gastroenterol J. 2019 06; 7(5):583-613.UE

Abstract

This guideline presents recommendations for the management of coeliac disease (CD) and other gluten-related disorders both in adults and children. There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. In a group of children the diagnosis may be made without biopsy if strict criteria are available. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. Slow-responsiveness occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms necessitate a review of the original diagnosis, exclude alternative diagnoses, confirm dietary adherence (dietary review and serology) and follow-up biopsy. In addition, evaluation to exclude complications of CD, such as refractory CD or lymphoma, should be performed. The guideline also deals with other gluten-related disorders, such as dermatitis herpetiformis, which is a cutaneous manifestation of CD characterized by granular IgA deposits in the dermal papillae. The skin lesions clear with gluten withdrawal. Also, less well-defined conditions such as non-coeliac gluten sensitivity (NCGS) and gluten-sensitive neurological manifestations, such as ataxia, have been addressed. Newer therapeutic modalities for CD are being studied in clinical trials but are not yet approved for use in practice.

Authors+Show Affiliations

Department of Gastroenterology, St. Antonius Hospital, Nieuwegein, The Netherlands.Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.Department of Translational Medical Science, Section of Paediatrics, University of Naples, Naples, Italy.Department of Paediatric Gastroenterology, Hospital Universitari Sant Joan de Reus, Universitat Rovira I Virgili, IISPV, Reus, Spain.Gastroenterology and Liver Unit, Royal Hallamshire Hospital & University of Sheffield, Sheffield, UK.Gastroenterology Department, Hôpital Européen Georges Pompidou, Paris, France.Department of Gastroenterology, VU Medical Centre, Amsterdam, The Netherlands.Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway. KG Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway.

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

31210940

Citation

Al-Toma, Abdulbaqi, et al. "European Society for the Study of Coeliac Disease (ESsCD) Guideline for Coeliac Disease and Other Gluten-related Disorders." United European Gastroenterology Journal, vol. 7, no. 5, 2019, pp. 583-613.
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;7(5):583-613.
Al-Toma, A., Volta, U., Auricchio, R., Castillejo, G., Sanders, D. S., Cellier, C., Mulder, C. J., & Lundin, K. E. A. (2019). European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterology Journal, 7(5), 583-613. https://doi.org/10.1177/2050640619844125
Al-Toma A, 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;7(5):583-613. PubMed PMID: 31210940.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. AU - Al-Toma,Abdulbaqi, AU - Volta,Umberto, AU - Auricchio,Renata, AU - Castillejo,Gemma, AU - Sanders,David S, AU - Cellier,Christophe, AU - Mulder,Chris J, AU - Lundin,Knut E A, Y1 - 2019/04/13/ PY - 2019/01/07/received PY - 2019/03/25/accepted PY - 2019/6/19/entrez PY - 2019/6/19/pubmed PY - 2019/6/19/medline KW - Coeliac disease KW - coeliac neuropathy KW - dermatitis herpetiformis KW - enteropathy associated T-cell lymphoma KW - gluten ataxia KW - neurocoeliac KW - non-coeliac gluten sensitivity KW - refractory coeliac disease KW - seronegative coeliac disease KW - slow-responder coeliac SP - 583 EP - 613 JF - United European gastroenterology journal JO - United European Gastroenterol J VL - 7 IS - 5 N2 - This guideline presents recommendations for the management of coeliac disease (CD) and other gluten-related disorders both in adults and children. There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. In a group of children the diagnosis may be made without biopsy if strict criteria are available. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. Slow-responsiveness occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms necessitate a review of the original diagnosis, exclude alternative diagnoses, confirm dietary adherence (dietary review and serology) and follow-up biopsy. In addition, evaluation to exclude complications of CD, such as refractory CD or lymphoma, should be performed. The guideline also deals with other gluten-related disorders, such as dermatitis herpetiformis, which is a cutaneous manifestation of CD characterized by granular IgA deposits in the dermal papillae. The skin lesions clear with gluten withdrawal. Also, less well-defined conditions such as non-coeliac gluten sensitivity (NCGS) and gluten-sensitive neurological manifestations, such as ataxia, have been addressed. Newer therapeutic modalities for CD are being studied in clinical trials but are not yet approved for use in practice. SN - 2050-6406 UR - https://www.unboundmedicine.com/medline/citation/31210940/full_citation L2 - https://journals.sagepub.com/doi/10.1177/2050640619844125?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -