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The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options

Celiac disease (CD) is an autoimmune disorder that affects genetically predisposed individuals who are sensitive to gluten and related proteins. It affects children and adults with increasing prevalence in the older age groups. Both adaptive and innate immune responses play role in CD pathogenesis w...

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Autores principales: Tarar, Zahid Ijaz, Zafar, Muhammad Usman, Farooq, Umer, Basar, Omer, Tahan, Veysel, Daglilar, Ebubekir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767653/
https://www.ncbi.nlm.nih.gov/pubmed/34693776
http://dx.doi.org/10.1177/23247096211053702
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author Tarar, Zahid Ijaz
Zafar, Muhammad Usman
Farooq, Umer
Basar, Omer
Tahan, Veysel
Daglilar, Ebubekir
author_facet Tarar, Zahid Ijaz
Zafar, Muhammad Usman
Farooq, Umer
Basar, Omer
Tahan, Veysel
Daglilar, Ebubekir
author_sort Tarar, Zahid Ijaz
collection PubMed
description Celiac disease (CD) is an autoimmune disorder that affects genetically predisposed individuals who are sensitive to gluten and related proteins. It affects children and adults with increasing prevalence in the older age groups. Both adaptive and innate immune responses play role in CD pathogenesis which results in damage of lamina propria and deposition of intraepithelial lymphocytes. There are other proposed mechanisms of CD pathogenesis like gastrointestinal infections, intestinal microbiota, and early introduction of gluten. The diagnosis of CD is based on clinical symptoms and serological testing, though a majority of cases are asymptomatic, and small intestinal biopsies are required to confirm the diagnosis. Celiac disease is generally associated with other autoimmune diseases, and it is advisable to test these patients for diseases like type 1 diabetes mellitus, Addison’s disease, thyroid diseases, inflammatory bowel disease, and autoimmune hepatitis. The patient with a new diagnosis of CD requires close follow-up after starting treatment to see symptom improvement and check dietary compliance. A newly diagnosed patient is advised to follow with a dietitian to better understand the dietary restrictions as about 20% of patients stay symptomatic even after starting treatment due to noncompliance or poor understanding of diet restrictions. The most effective treatment for CD is a gluten-free diet, but work on non-dietary therapy is in process and few medications are in the clinical trial phase.
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spelling pubmed-87676532022-01-20 The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options Tarar, Zahid Ijaz Zafar, Muhammad Usman Farooq, Umer Basar, Omer Tahan, Veysel Daglilar, Ebubekir J Investig Med High Impact Case Rep Review Celiac disease (CD) is an autoimmune disorder that affects genetically predisposed individuals who are sensitive to gluten and related proteins. It affects children and adults with increasing prevalence in the older age groups. Both adaptive and innate immune responses play role in CD pathogenesis which results in damage of lamina propria and deposition of intraepithelial lymphocytes. There are other proposed mechanisms of CD pathogenesis like gastrointestinal infections, intestinal microbiota, and early introduction of gluten. The diagnosis of CD is based on clinical symptoms and serological testing, though a majority of cases are asymptomatic, and small intestinal biopsies are required to confirm the diagnosis. Celiac disease is generally associated with other autoimmune diseases, and it is advisable to test these patients for diseases like type 1 diabetes mellitus, Addison’s disease, thyroid diseases, inflammatory bowel disease, and autoimmune hepatitis. The patient with a new diagnosis of CD requires close follow-up after starting treatment to see symptom improvement and check dietary compliance. A newly diagnosed patient is advised to follow with a dietitian to better understand the dietary restrictions as about 20% of patients stay symptomatic even after starting treatment due to noncompliance or poor understanding of diet restrictions. The most effective treatment for CD is a gluten-free diet, but work on non-dietary therapy is in process and few medications are in the clinical trial phase. SAGE Publications 2021-10-25 /pmc/articles/PMC8767653/ /pubmed/34693776 http://dx.doi.org/10.1177/23247096211053702 Text en © 2021 American Federation for Medical Research https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Tarar, Zahid Ijaz
Zafar, Muhammad Usman
Farooq, Umer
Basar, Omer
Tahan, Veysel
Daglilar, Ebubekir
The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
title The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
title_full The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
title_fullStr The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
title_full_unstemmed The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
title_short The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
title_sort progression of celiac disease, diagnostic modalities, and treatment options
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767653/
https://www.ncbi.nlm.nih.gov/pubmed/34693776
http://dx.doi.org/10.1177/23247096211053702
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