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European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders
Open accessAbstract
This guideline presents recommendations for the management of coeliac disease (CD) and other gluten-related disorders both in adults and children. There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. In a group of children the diagnosis may be made without biopsy if strict criteria are available. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. Slow-responsiveness occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms necessitate a review of the original diagnosis, exclude alternative diagnoses, confirm dietary adherence (dietary review and serology) and follow-up biopsy. In addition, evaluation to exclude complications of CD, such as refractory CD or lymphoma, should be performed. The guideline also deals with other gluten-related disorders, such as dermatitis herpetiformis, which is a cutaneous manifestation of CD characterized by granular IgA deposits in the dermal papillae. The skin lesions clear with gluten withdrawal. Also, less well-defined conditions such as non-coeliac gluten sensitivity (NCGS) and gluten-sensitive neurological manifestations, such as ataxia, have been addressed. Newer therapeutic modalities for CD are being studied in clinical trials but are not yet approved for use in practice.
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“Tissue transglutaminase IgA is 98% sensitive and specific for coeliac disease, however intestinal biopsy is recommended to confirm the diagnosis.727”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [727]
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“Five CPGs for populations with celiac disease [[52], [53], [54], [55], [56]] recommended complete avoidance of gluten, but gluten was not mentioned by any other CPG.”
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Self-citationMachine learning-based prediction of celiac antibody seropositivity by biochemical test parameters
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Self-citationAvoidance of gluten in children with non-celiac gluten sensitivity is debatable
Devulapalli, C. S. (2021) · doi:10.52768/jjgastro/1014 · Cited by 1
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Self-citationAdherencia a la dieta sin gluten en celíacos del Paraguay
Delor, R. E. R., & Chamorro-Aguilera, M. E. (2022) · Revista de Gastroenterología de México · doi:10.1016/j.rgmx.2021.10.009 · Cited by 1
“…Muchos encuestados que refirieron haber sido diag-nosticados en forma casual fue porque tienen parientes consanguíneos con EC Se aconseja a la familia del nuevo celíaco la realización de pruebas serológicas para tami-zaje de EC, aunque sean asintomáticos, por tratarse de un grupo de riesgo 1,28 .”
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“Since none of the serological tests for CD have a reputation of being an ideal test with perfect diagnostic performance, it is recommended to combine two tests.[30] A combination of IgA anti‐TTG and EMA is recommended by most authors.”
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“Five guidelines (17, 19, 20, 22, 24) determined that a biopsy is essential for diagnosis, even with positive serology.”
BackgroundMethodInfluentialA Case of Celiac Disease Admitted to Our Clinic with Symptoms of Malabsorption
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Celiac disease, non-celiac gluten sensitivity and irritable bowel syndrome: diagnostic difficulties
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“In fact, the gluten-free diet (GFD) currently represents the standard treatment of CD and the only one needed in more than 70% of patients [18].”
BackgroundOsnach, S. A., Bregovskiy, V. B., Процко, В. Г., et al. (2023) · Clinical and Experimental Surgery Petrovsky journal · doi:10.33029/2308-1198-2023-11-2-132-139 · Cited by 1
Leković, Z., Radlović, V., Mladenović, M., Dučić, S., Bukva, B., Rosić, P., & Radlović, N. (2023) · Medicinska istrazivanja · doi:10.5937/medi56-43306 · Cited by 1
Putri, M. T., Puteri, M. M., Tedjosasongko, U., & Ohara, M. (2024) · World Journal of Advanced Research and Reviews · doi:10.30574/wjarr.2024.21.1.0069 · Cited by 1
“A GFD can provide physical and psychological benefits for children with ADHD and for those at risk of suffering from celiac disease, dermatitis herpetiformis, and gluten sensitivity 28 .”
BackgroundCeliac disease in pediatric patients
Guandalini, S., & Sansotta, N. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-13359-6.00010-8 · Cited by 2
Gut microbiota and prospects for probiotics in paediatric celiac disease
Хавкин, А. И., Yablokova, E. A., Шаповалова, Н. С., & Ильинична, Е. М. (2024) · Archives of Pediatrics and Pediatric Surgery · doi:10.31146/2949-4664-apps-2-2-104-115 · Cited by 1
Rižnik, P., Trop, T. K., Klemenak, M., et al. (2024) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-024-01045-9 · Cited by 1
“While ESPGHAN guidelines have reached acceptance in various regions over the years [8–11], guidelines for adults still emphasize the importance of biopsy confirmation for CD diagnosis [12, 13].”
BackgroundSKELETAL HEALTH ASSESSMENT IN BRAZILIAN MEN WITH CELIAC DISEASE AT DIAGNOSIS: HOW IMPORTANT IS IT?
Kotze, L. M. D. S., Skare, T. L., Kotze, L. R., & Nisihara, R. (2024) · Arquivos de Gastroenterologia · doi:10.1590/s0004-2803.24612024-005 · Cited by 1
Kumar, S., Ankush, Ram, S., et al. (2024) · Journal of King Saud University - Science · doi:10.1016/j.jksus.2024.103335 · Cited by 1
Assessment of QRS duration and presence of fragmented QRS in patients with celiac disease
Güven, İ. E., & Candemir, M. (2024) · International Journal of Medical Sciences · doi:10.7150/ijms.98131 · Cited by 1
“Celiac Disease (CD) is a chronic inflammatory disorder characterized by an impaired immune response to gluten [1].”
BackgroundDiagnostic value of serological markers for celiac disease in children
Dmitrieva, Y. А., Zakharova, I. N., Osmanov, I. M., Gostyukhina, A. D., Teslenko, S. E., Radchenko, E. R., Ренатовна, М. А., & Скоробогатова, Е. В. (2024) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2024-315 · Cited by 1
Dakó, E., Dakó, S., Papp, V., et al. (2024) · Nutrients · doi:10.3390/nu16172964 · Cited by 1
Vorobjova, T., Metsküla, K., Salumäe, L., Uibo, O., Heilman, K., & Uibo, R. (2025) · Journal of Molecular Histology · doi:10.1007/s10735-024-10340-z · Cited by 1
“The diagnosis of CD was established based on the European Society for Paediatric Gastroenterology, Hepathology and Nutrition (ESPGHAN) criteria (Walker-Smith et al. 1990; Kelly et al. 2015) and the European Society for the Study of Coeliac Disease (ESsCD) guidelines (Al-Toma et al. 2019).”
Uma análise acerca dos aspectos clínicos da Doença Celíaca
Neves, J. P. C., & Júnior, H. S. D. F. (2025) · Revista Eletrônica Acervo Médico · doi:10.25248/reamed.e18506.2025 · Cited by 1
A Narrative Review of Celiac Disease in India with a Focus on its Link with Type 1 Diabetes
Tharunika, S., Mohan, V., Anjana, R. M., & Amutha, A. (2025) · Journal of Diabetology · doi:10.4103/jod.jod_170_24 · Cited by 1
Prevalence of genetic markers of celiac disease in different populations
Yankina, G. N., Кондратьева, Е. И., & Лошкова, Е. В. (2025) · Archives of Pediatrics and Pediatric Surgery · doi:10.31146/2949-4664-apps-2-3-27-39 · Cited by 1
Follow-up of Celiac Disease After Diagnosis
Elli, L., Makharia, G. K., Leffler, D. A., Scaramella, L., & Malamut, G. (2025) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/j.giec.2024.12.004 · Cited by 1
Mantsaeva, M. E., Иванович, К. Д., & Borisov, A. G. (2025) · FARMAKOEKONOMIKA Modern Pharmacoeconomics and Pharmacoepidemiology · doi:10.17749/2070-4909/farmakoekonomika.2025.304 · Cited by 1
La diagnosi della malattia celiaca: introduzione alle linee guida SIPMeL 2025
Barrale, M., Brusca, I., Sorrentino, M. C., Villalta, D., & Bizzaro, N. (2025) · La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine · doi:10.23736/s1825-859x.25.00281-6 · Cited by 3
Clinical Picture of Celiac disease: Experience from a health care provider in Arabia
(2020) · Open Journal of Gastroenterology and Hepatology · doi:10.28933/ojgh-2020-05-1305 · Cited by 1
CASE STUDY: LATE DIAGNOSIS OF COELIAC DISEASE
Zhussupbekova, L., Ibraeva, A. K., Dzhaksalykova, K. K., Нуркина, Д. А., Amanzholova, Z. A., & Kubaydullina, A. K. (2020) · Научное обозрение Медицинские науки (Scientific Review Medical Sciences) · doi:10.17513/srms.1123 · Cited by 1
Metadata
- Authors
- Al-Toma, A., Volta, U., Auricchio, R., Castillejo, G., Sanders, D. S., Cellier, C., Mulder, C. J., & Lundin, K. E. A.
- Affiliations
- St. Antonius Ziekenhuis (NL)
- University of Bologna (IT)
- University of Naples Federico II (IT)
- Institut de Recerca Biomèdica Catalunya Sud (ES)
- Royal Hallamshire Hospital (GB)
- Hôpital Européen Georges-Pompidou (FR)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Oslo University Hospital (NO)
- Corresponding author
- Al-Toma, Abdulbaqi
- ORCID
- Venue
- United European Gastroenterology Journal
- Publisher
- Wiley
- Published
- 2019-06
- Volume
- 7
- Issue
- 5
- Pages
- 583-613
- ISSN
- 2050-6406 (ISSN-L)
- 2050-6414
- PMC
- PMC6545713
- OpenAlex
- W2937921992
- Cited by
- 1,012
- References
- 0
- Citations by year
- 2026: 93 · 2025: 162 · 2024: 177 · 2023: 167 · 2022: 143 · 2021: 157 · 2020: 92 · 2019: 17
- FWCI
- 93.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- United European Gastroenterology Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Gastroenterology › Eosinophilic Esophagitis
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Wheat and Barley Genetics and Pathology
- Keywords
- celiac disease, gluten-related disorders, gluten-free diet, serological testing, duodenal biopsy, refractory celiac disease, dermatitis herpetiformis, non-celiac gluten sensitivity, ataxia, dietary adherence, undiagnosed celiac disease, prevalence
- MeSH terms
- Adult, Celiac Disease, Child, Dermatitis Herpetiformis, Humans, Immunotherapy, Quality of Life, Dietary Supplements, Diet, Gluten-Free
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