The prevalence, pathogenesis and diagnostics of celiac disease

Most of the proteins in food that are responsible for immune reactions in CD are the prolamins. Because of their high glutamine content and certain specific sequence patterns, prolamins are resistant to gastrointestinal enzymes that protect the small intestine from autoimmune response. New ESPGHAN diagnostic guidelines In September 2019, the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) published updated guidelines for the diagnosis of CD. Since guidelines were last released in 2012, there has been the development of more sensitive and specific assays to detect antibodies leading to a refinement in thinking about diagnostics testing for CD. If TGA-IgA is >10 times the upper limit of normal (10xULN) and the family agrees, a no-biopsy diagnosis need be applied, provided that endomysial antibodies (EMA-IgA) test positive in a second blood sample.