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Coeliac disease

Journal

LANCET
Volume 399, Issue 10344, Pages 2413-2426

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(22)00794-2

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Coeliac disease is an autoimmune disorder primarily affecting the small intestine and caused by the ingestion of gluten. It has a complex immune response mechanism. The disease has diverse clinical symptoms, including gastrointestinal symptoms, extraintestinal manifestations, and subclinical cases. Diagnosis involves serological testing and small-intestinal biopsy, and treatment includes a gluten-free diet.
Coeliac disease is an autoimmune disorder that primarily affects the small intestine, and is caused by the ingestion of gluten in genetically susceptible individuals. Prevalence in the general population ranges from 0??5% to 2%, with an average of about 1%. The development of the coeliac enteropathy depends on a complex immune response to gluten proteins, including both adaptive and innate mechanisms. Clinical presentation of coeliac disease is highly variable and includes classical and non-classical gastrointestinal symptoms, extraintestinal manifestations, and subclinical cases. The disease is associated with a risk of complications, such as osteoporosis and intestinal lymphoma. Diagnosis of coeliac disease requires a positive serology (IgA anti-transglutaminase 2 and anti-endomysial antibodies) and villous atrophy on small-intestinal biopsy. Treatment involves a gluten-free diet; however, owing to the high psychosocial burden of such a diet, research into alternative pharmacological treatments is currently very active.

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