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08/11/2014 - Recommendations for the diagnosis of Coeliac Disease

Coeliac disease is a chronic auto-immune inflammatory enteropathy caused by a food allergen, gliadin, which is a gluten protein.
Diagnosis is based on a combination of evidence:

- clinical
The picture is highly varied, from an asymptomatic form to severe malnutrition. The most common symptoms are abdominal pain, chronic diarrhoea, weight loss, bone disease, anaemia and asthenia.

- serology :
Screening for antiendomysial  and antitransglutaminase IgA antibodies has its place in the diagnostic process for Coeliac disease. In the event of IgA deficiency, this will be replaced with antiendomysial and antitransglutaminase IgG.

- histology:
When serology testing is positive, small intestine biopsies are indicated, in order to confirm the diagnosis so that, if this be the case,  a gluten-free diet can be started.

Treatment for coeliac disease is based upon a gluten-free diet.
The disappearance of antiendomysial and antitransglutaminase antibodies is linked to compliance with treatment and encourages the patient to continue with his or her diet.


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