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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]
In the citing paper
“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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Pasricha, S.-R., Tye-Din, J., Muckenthaler, M. U., & Swinkels, D. W. (2021) · The Lancet · doi:10.1016/s0140-6736(20)32594-0 · Cited by 1,069
Catassi, C., Verdu, E. F., Bai, J. C., & Lionetti, E. (2022) · The Lancet · doi:10.1016/s0140-6736(22)00794-2 · Cited by 547
Pennazio, M., Rondonotti, E., Despott, E. J., Dray, X., Keuchel, M., Moreels, T. G., Sanders, D. S., Spada, C., Carretero, C., Valdivia, P. C., et al. (2022) · Endoscopy · doi:10.1055/a-1973-3796 · Cited by 338
“RCD-2 is less frequent but characterized by a severe prognosis with mortality of up to 50% in 5 years and a higher risk of neoplastic evolution [252].”
BackgroundSelf-citationClinical practice guidelines for the care of girls and women with Turner syndrome.
Gravholt, C. H., Andersen, N. H., Christin-Maitre, S., Davis, S. M., Duijnhouwer, A., Gawlik, A., Maciel-Guerra, A. T., Gutmark-Little, I., Fleischer, K., Hong, D., et al. (2024) · European Journal of Endocrinology · doi:10.1093/ejendo/lvae050 · Cited by 224
Kamiński, M., Skonieczna‐Żydecka, K., Nowak, J. K., & Stachowska, E. (2020) · Nutrition · doi:10.1016/j.nut.2020.110759 · Cited by 217
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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