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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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Alpaslan, C., & Erge, S. (2025) · Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Dergisi · doi:10.21020/husbfd.1475876
Fiz‐López, A., Prado, Á. D., Arribas‐Rodríguez, E., del Hierro, A. G., de Castro, C. G., Izquierdo, S., Martín‐Muñoz, Á., Corrales-Cruz, D., Cuesta‐Sancho, S., Garrote, J. A., et al. (2025) · Clinical & Experimental Immunology · doi:10.1093/cei/uxaf058
ЦУКРОВИЙ ДІАБЕТ 1 ТИПУ ТА ЦЕЛІАКІЯ: ОГЛЯД ЛlТЕРАТУРИ
Khyzhnyak, O., Микитюк, М., Karachentsev, Y. I., Oleksyk, O. T., & Гавриш, Т. Ю. (2025) · PROBLEMS OF ENDOCRINE PATHOLOGY · doi:10.21856/j-pep.2025.3.05
Nurmi, R., Beteta, C. T., Kurppa, K., et al. (2025) · Journal of Internal Medicine · doi:10.1111/joim.70025
“HLA determination could help to exclude CeD, although the absence of at-risk haplotypes is rare among seropositive individuals [28, 37].”
Influential
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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