Clinical management of coeliac disease

. Ludvigsson JF, Green PH (Örebro University Hospital, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital and Karolinska Institutet, Sweden; and Columbia University College of Physicians and Surgeons, New York, NY, USA). Clinical management of coeliac disease (Symposium). J Intern Med 2011; 269: 560–571. Objective. To describe the prevalence of Coeliac disease (CD) and its clinical management. Methods. Narrative review. Results. Coeliac disease (CD) is an immune‐mediated disorder that primarily affects the gastrointestinal (GI) tract. Recent data suggest a prevalence of about 1% in most Western countries, a figure that likely represents an increase in the prevalence of CD. Risk groups include those who are members of families with individuals who have CD as well as those with Type I diabetes and a variety of autoimmune diseases. Whereas biopsy is the gold standard in diagnosis, serological tests are crucial in determining who should undergo endoscopy and biopsy. HLA testing should be used only to rule out CD. Currently, a gluten‐free diet is the only available therapy. Conclusion. In conclusion, CD is one of the most common immune‐mediated disorders in the Western world. It should be considered in patients with a number of varying GI and non‐GI symptoms, as well as in high‐risk groups that include first‐degree relatives.