Enfermedad celíaca

Coeliac disease is a systemic autoimmune disorder that is triggered by the ingestion of gluten and associated prolamins in individuals with genetic susceptibility (mainly HLA), characterised by a variable combination of specific antibodies: gluten-dependent clinical manifestations, specific coeliac disease antibodies, HLA-DQ2 and/or DQ8 haplotype and enteropathy. The specific antibodies consist of anti-TG2 antibodies, including endomysial and deamidated gliadin peptide antibodies. In childhood and adolescence, the intestinal biopsy could be omitted in symptomatic subjects with anti-TG2-IgA antibody titres > 10 times the cut-off point, verified by a positive antibodies endomysial and HLA-DQ2 and/or DQ8, and only in this case, the diagnosis could be made and treatment started with gluten-free diets. In all the rest of the cases, a first intestinal biopsy, before withdrawal of the gluten diet, is mandatory to prevent incorrect diagnoses.