American Gastroenterological Association (AGA) Institute Technical Review on the Diagnosis and Management of Celiac Disease

Predictors of Family Risk for Celiac Disease: A Population-Based Study

“…1,34 Thus, IgA deficiency is possible in 3 "seronegative" relatives with abnormal histology. Indeed, IgA deficiency was probable in one, as the IgG-class tTGA was elevated.…”

“…CD was confirmed by biopsy and response to GFD. 1 Mayo Foundation and OMC Institutional Review Boards approved this study.…”

“…Celiac disease (CD) affects ∼1% of Caucasians and causes damage to the small-intestine that is triggered by and dependent on the ingestion of gluten 1,2,3 Testing at-risk groups may unmask CD. [4][5][6] Familial aggregation is common: a large American study that recruited relatives during CD-support group meetings identified ∼5% of first-degree relatives with CD.…”

“…10 Thus, the absence of these genotypes exclude CD-risk. 1,11 Undiagnosed patients may have chronic symptoms, severe complications, and excess mortality. 12,13,14 Widespread availability of accurate serology for CD facilitates case-finding noninvasively.…”

Management of Celiac Disease: Beyond the Gluten-Free Diet

“…Currently, the only available management option is a life-long gluten-free diet 2 ; however, the study from Finland by Lähdeaho et al 3 suggests that an oral glutenase to degrade small amounts of dietary gluten can attenuate gluten-induced small intestinal mucosal injury in patients with celiac disease who are consuming a gluten-free diet that contains small amounts of gluten. The need for a treatment above and beyond the gluten-free diet may seem less relevant at a time when gluten-free food products are far more available in stores and restaurants than ever before.…”