Atypical celiac disease: from recognizing to managing
Open accessAbstract
The nonclassic clinical presentation of celiac disease (CD) becomes increasingly common in physician's daily practice, which requires an awareness of its many clinical faces with atypical, silent, and latent forms. Besides the common genetic background (HLA DQ2/DQ8) of the disease, other non-HLA genes are now notably reported with a probable association to atypical forms. The availability of high-sensitive and specific serologic tests such as antitissue transglutuminase, antiendomysium, and more recent antideamidated, gliadin peptide antibodies permits to efficiently uncover a large portion of the submerged CD iceberg, including individuals having conditions associated with a high risk of developing CD (type 1 diabetes, autoimmune diseases, Down syndrome, family history of CD, etc.), biologic abnormalities (iron deficiency anemia, abnormal transaminase levels, etc.), and extraintestinal symptoms (short stature, neuropsychiatric disorders, alopecia, dental enamel hypoplasia, recurrent aphtous stomatitis, etc.). Despite the therapeutic alternatives currently in developing, the strict adherence to a GFD remains the only effective and safe therapy for CD.
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Celiac disease is more common in Hashimoto's thyroiditis and causes lymphocytic infiltration and enterocyte atrophy, reducing intestinal surface area for levothyroxine absorption and increasing dose needs; it can present without gastrointestinal symptoms.
“Celiac disease is more prevalent in patients with Hashimoto's thyroiditis 62 and causes lymphocytic infiltration and enterocyte atrophy, leading to a progressive reduction in the available intestinal surface area for LT4 absorption, thereby increasing LT4 dosage requirements.3 It can also present atypically without gastrointestinal symptoms, further complicating its recognition.63”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [63]
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Refractory hypothyroidism: unraveling the complexities of diagnosis and management
Quiroz-Aldave, J. E., Concepción-Zavaleta, M. J., Durand-Vásquez, M. D. C., Concepción-Urteaga, L. A., Gamarra-Osorio, E. R., Suárez-Rojas, J., Rafael-Robles, L. D. P., Paz-Ibarra, J., & Román-González, A. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.09.003 · Cited by 14 · see citing works
- Authors
- Admou, B., Essaadouni, L., Krati, K., Zaher, K., Sbihi, M., Chabaa, L., Belaabidia, B., & Alaoui-Yazidi, A.
- Affiliations
- Cadi Ayyad University (MA)
- Centre Hospitalier Universitaire Mohammed VI (MA)
- Service of Peadiatrics, University Hospital Center, Marrakech, Morocco
- Corresponding author
- Admou, B.
- ORCID
- Admou, B.
- Venue
- Gastroenterology Research and Practice
- Publisher
- Hindawi Limited
- Published
- 2012
- Volume
- 2012
- Pages
- 1-9
- ISSN
- 1687-6121 (ISSN-L)
- 1687-630X
- PMC
- PMC3395124
- OpenAlex
- W2143832683
- Cited by
- 66
- References
- 91
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 9 · 2022: 3 · 2021: 10 · 2020: 2 · 2019: 4 · 2018: 8 · 2017: 5 · 2016: 2 · 2015: 6 · 2014: 3 · 2013: 8 · 2012: 1
- FWCI
- 5.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Gastroenterology Research and Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Wheat and Barley Genetics and Pathology
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Keywords
- atypical celiac disease, silent celiac disease, latent celiac disease, HLA-DQ2/DQ8, serological diagnosis, anti-tissue transglutaminase antibodies, anti-endomysial antibodies, deamidated gliadin peptide antibodies, extraintestinal manifestations, iron deficiency anemia, short stature, hair loss, type 1 diabetes, Down syndrome, gluten-free diet, celiac disease management
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