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Licensed Unlicensed Requires Authentication Published by De Gruyter June 28, 2010

Coeliac disease – a diagnostic and therapeutic challenge

Katri Kaukinen, Katri Lindfors, Pekka Collin, Outi Koskinen and Markku Mäki


During the past 20 years the diagnosis of coeliac disease has improved significantly. However, at the same time the true prevalence of the condition has doubled, involving more than 2% of the population in some countries. Due to mild or atypical symptoms, the diagnosis remains a challenge for the health care system. Highly sensitive and specific serum endomysial and transglutaminase-2 antibody tests are helpful in identifying patients for diagnostic endoscopy and small-bowel biopsy. The diagnosis of the disease is still based on the demonstration of gluten-induced small-bowel mucosal villous atrophy with crypt hyperplasia. However, coeliac disease may manifest itself before the development of the overt small-intestinal lesion. Positive endomysial and transglutaminase antibodies in patients with normal small-bowel mucosal villous architecture may indicate early stage coeliac disease. Currently, the only effective treatment for the condition is a life-long strict gluten-free diet. Long-term regular follow-up of patients is recommended in order to maintain good adherence to the diet.

Clin Chem Lab Med 2010;48:1205–16.

Corresponding author: Dr. Katri Kaukinen, MD, PhD, Medical School, Finn-Medi 3, 33014 University of Tampere, Finland Phone: +358 3 3551 8403, Fax: +358 3 3551 8402,

Received: 2010-2-12
Accepted: 2010-3-14
Published Online: 2010-06-28
Published in Print: 2010-09-01

©2010 by Walter de Gruyter Berlin New York

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