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    Approach To Diagnosis of Celiac Disease - UpToDate

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    miguel
    This algorithm outlines the diagnostic approach for suspected celiac disease in an adult patient on a gluten containing diet. It involves initial testing of tissue transglutaminase antibodies and if positive, further testing including intestinal biopsy and genetic testing, with diagnosis confirmed if biopsy shows characteristic changes and serology and genetics are consistent with celiac disease.

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    Approach To Diagnosis of Celiac Disease - UpToDate

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    miguel
    217 views2 pages
    This algorithm outlines the diagnostic approach for suspected celiac disease in an adult patient on a gluten containing diet. It involves initial testing of tissue transglutaminase antibodies and if positive, further testing including intestinal biopsy and genetic testing, with diagnosis confirmed if biopsy shows characteristic changes and serology and genetics are consistent with celiac disease.

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    Approach to diagnosis of celiac disease - UpToDate

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    This algorithm outlines the diagnostic approach for suspected celiac disease in an adult patient on a gluten containing diet. It involves initial testing of tissue transglutaminase antibodies and if positive, further testing including intestinal biopsy and genetic testing, with diagnosis confirmed if biopsy shows characteristic changes and serology and genetics are consistent with celiac disease.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    217 views2 pages

    Approach To Diagnosis of Celiac Disease - UpToDate

    Uploaded by

    miguel
    This algorithm outlines the diagnostic approach for suspected celiac disease in an adult patient on a gluten containing diet. It involves initial testing of tissue transglutaminase antibodies and if positive, further testing including intestinal biopsy and genetic testing, with diagnosis confirmed if biopsy shows characteristic changes and serology and genetics are consistent with celiac disease.

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    © All Rights Reserved
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    Approach to diagnosis of celiac disease - UpToDate 8/7/23 12:54

    Official reprint from UpToDate®


    www.uptodate.com © 2023 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

    Diagnostic approach for suspected celiac disease in an adult patient on gluten containing diet*

    This algorithm is intended for use in conjunction with additional UpToDate content on celiac disease. Refer to the UpToDate topic
    on diagnosis of celiac disease in adults for additional details of diagnostic testing.

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    Approach to diagnosis of celiac disease - UpToDate 8/7/23 12:54

    tTG: tissue transglutaminase; IgA: immunoglobulin A; DGP: deamidated gliadin peptide; IgG: immunoglobulin G; EMA: endomysial
    antibody; HLA: human leukocyte antigen.
    * Testing for celiac disease should be performed in adults with suggestive gastrointestinal or extraintestinal signs/symptoms of
    celiac disease. Testing for celiac disease should ideally be performed while patients are on a gluten containing diet.
    ¶ The histologic severity of intestinal lesions in celiac disease are graded using the Marsh-Oberhuber classification. Marsh 2 and 3
    are consistent with a diagnosis of celiac disease in individuals with positive celiac-specific serology. Marsh 1 is equivocal and Marsh
    0 is normal. Refer to UpToDate content on the diagnosis of celiac disease.
    Δ The intestinal biopsy should be reviewed by a pathologist familiar with celiac disease to look for subtle abnormalities of celiac
    disease.
    ◊ Absence of alleles encoding DQ2 or DQ8 excludes celiac disease.
    § Other conditions associated with lymphocytic duodenosis include Helicobacter pylori infection, medications (eg, non-steroidal
    antiinflammatory drugs), small bowel bacterial overgrowth, and systemic autoimmune disorders.
    ¥ Individuals with positive celiac-specific serology but Marsh 0 or 1 intestinal lesions on duodenal biopsy have potential celiac
    disease. Individuals with potential celiac disease should be evaluated and monitored further depending upon their clinical
    circumstances. Symptomatic patients with potential celiac disease are likely to benefit from treatment with a gluten free diet.
    Asymptomatic patients can remain on a normal diet unless clinical features of celiac disease develop.
    ‡ There are several causes of non-celiac enteropathy (villous atrophy in duodenum). Potential causes include giardiasis, small-bowel
    bacterial overgrowth, and common variable immunodeficiency. For a more comprehensive list of causes, refer to UpToDate content
    on diagnosis of celiac disease.
    † An improvement in histology (with or without complete resolution) on a gluten free diet in patients with villous atrophy strongly
    supports a diagnosis of celiac disease.

    Graphic 119163 Version 1.0

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