[Histological diagnosis and complications of celiac disease. Update according to the new S2k guidelines]

Pathologe. 2015 Mar;36(2):197-205; quiz 206-7. doi: 10.1007/s00292-015-0006-2.
[Article in German]

Abstract

Celiac disease is a relatively common immunological systemic disease triggered by the protein gluten in genetically predisposed individuals. Classical symptoms like chronic diarrhea, steatorrhea, weight loss and growth retardation are nowadays relatively uncommon. Diagnostic workup includes serological tests for IgA antibodies against tissue transglutaminase 2 (anti-TG2-IgA) and total IgA and histology of duodenal biopsies. Histomorphological classification should be done according to the modified Marsh-Oberhuber classification. Diagnosis of celiac disease should be based on serological, clinical, and histological findings. The only treatment is a life-long gluten-free diet. Unchanged or recurrent symptoms under gluten-free diet may indicate refractory celiac disease. Enteropathy-associated T-cell lymphoma and adenocarcinomas of the small intestine are known complications of celiac disease.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / pathology
  • Autoantibodies / blood
  • Biopsy
  • Celiac Disease / complications*
  • Celiac Disease / diet therapy
  • Celiac Disease / pathology*
  • Cell Transformation, Neoplastic / pathology
  • Diet, Gluten-Free
  • Duodenal Neoplasms / pathology
  • Duodenum / pathology
  • GTP-Binding Proteins / immunology
  • Guideline Adherence*
  • Humans
  • Immunoglobulin A / blood
  • Lymphoma, T-Cell / pathology
  • Protein Glutamine gamma Glutamyltransferase 2
  • Recurrence
  • Transglutaminases / immunology

Substances

  • Autoantibodies
  • Immunoglobulin A
  • TGM2 protein, human
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases
  • GTP-Binding Proteins