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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Volume 48, Issue 9 (Sep 2010)


Coeliac disease – a diagnostic and therapeutic challenge

Katri Kaukinen
  • Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
  • Medical School, University of Tampere, Tampere, Finland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Katri Lindfors / Pekka Collin
  • Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
  • Medical School, University of Tampere, Tampere, Finland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Outi Koskinen / Markku Mäki
  • Paediatric Research Centre, University of Tampere and Tampere University Hospital, Tampere, Finland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2010-06-28 | DOI: https://doi.org/10.1515/CCLM.2010.241


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.

Keywords: coeliac disease; dermatitis herpetiformis; gluten-free diet; malignancy; oats; transglutaminase-2; villous atrophy

About the article

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: 2010-02-12

Accepted: 2010-03-14

Published Online: 2010-06-28

Published in Print: 2010-09-01

Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2010.241.

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©2010 by Walter de Gruyter Berlin New York. Copyright Clearance Center

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