The importance of and options available for screening of celiac disease
Makovický, P.; Rimárová, K.
Vnitrni Lekarstvi 57(2): 183-187
2011
ISSN/ISBN: 0042-773X PMID: 21416860 Document Number: 654913
Even though guidelines for diagnosing celiac disease have been compiled and accepted by a number of expert associations, this disease continues to be under-diagnosed in children and, particularly, in adults. This is even though numerous scientific papers, short case studies and review papers have been published highlighting this issue and consensually supporting screening methods. In addition, research results by reputable Czech and Slovak authors suggest that, at present, only a small proportion of all cases of celiac disease are correctly diagnosed. Considering this, methods to diagnose the disease in its initial stage are continuously being sought. Biopsy of the mucosa of the small intestine remains the gold standard when diagnosing celiac disease. Within the targeted diagnostic algorithm, less invasive techniques should precede biopsy. These are applied mainly in cases of atypical forms of the disease and are based on an examination of serum autoantibodies. Their application and use is advantageous from many perspectives. However, practical clinical experience showed that they are not always sufficiently specific and sensitive. Using their own experience and published literature, the authors discuss the issues of screening and diagnosing celiac disease. It is obvious that targeted screening will undoubtedly uncover new, mainly atypical forms of celiac disease, while some cases shall remain undiagnosed. The diagnosis of celiac disease can be made on the basis of clinical, laboratory and histopathological correlation, respecting possible difficulties.