[Celiac disease today]

Abstract

Recent studies have been reported for coeliac disease a new prevalence: 1:200 in Europe, 1:184 in Italy. These improvements have been possible for new diagnostic methods and techniques available today: antigliadin, antireticulin and antiendomysium antibodies. These serologic markers have been detected, in recent advances, new clinical presentations for coeliac disease: not only typical gastrointestinal symptoms (diarrhea, recurrent abdominal pain, etc), but many atypical symptoms have been described: sideropenic anemia, short stature, growth retardation, dermatitis herpetiformis, small alterations, alopecia, etc. New groups of patients have been also identified: some patients, clinically asymptomatic, with positive serology and a small intestinal biopsy suggestive for coeliac disease; they have shown histopathologic improvement with gluten free diet ("silent" coeliac disease). Another interesting group consists of asymptomatic patients with a positive serology for AGA and AEA antibodies, but normal gastrointestinal biopsy with free diet; they develop later in life, mucosal atrophy and normalization after gluten free diet ("latent" coeliac disease). It must be emphasized that classes of antibodies (in association with peroneal biopsy) have been identified in the last years, new clinical presentations of coeliac disease and new associations with other autoimmune pathologies.