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Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barley. [10]
The normal intestine: Illustration of the brush border membrane of small intestinal villi Wheat proteins interact with the immune system by means of DQ2-mediated programmed cell death (apoptosis) of the gut in sensitive individuals. New research is finding that the coeliac gut may be predisposed to sensitivity in the absence of HLA genetic factors.
This condition is known as refractory coeliac disease (RCD), defined as malabsorption due to gluten-related enteropathy (villous atrophy or elevated intraepitheal lymphocytes) after initial or subsequent failure of a strict gluten-free diet (usually 1 year) and after exclusion of any disorder mimicking coeliac disease.
Medical animation still showing flattened intestinal villi. Celiac disease (CD) is a chronic, multiple-organ autoimmune disorder primarily affecting the small intestine caused by the ingestion of wheat, barley, rye, oats, and derivatives, that appears in genetically predisposed people of all ages. [53]
Added difficulties for diagnosis are the fact that serological markers (anti-tissue transglutaminase [TG2]) are not always present, [25] and many people with coeliac may have minor mucosal lesions, without atrophy of the intestinal villi. [26] Coeliac disease affects approximately 1–2% of the general population all over the world [27] and is ...
Non-celiac gluten sensitivity (NCGS), or gluten intolerance, [1] is a syndrome in which people develop a variety of intestinal and/or extraintestinal symptoms that improve when gluten is removed from the diet, [32] after coeliac disease and wheat allergy are excluded. [33]
Most attention to anti-transglutaminase antibodies is given with respect to celiac disease. A recent study of children published in 2007 demonstrated that the level of ATA in correlates with the scalar Marsh score for the disease in the same patient. [9] High levels of ATA are found in almost all instances of celiac disease. [10]
For people eating a gluten-free diet who are unable to perform an oral gluten challenge, an alternative to identify a possible celiac disease is an in vitro gliadin challenge of small bowel biopsies, but this test is available only at selected specialized tertiary-care centers.