Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.
Diagnosis of gluten related disorders : celiac disease, wheat allergy and non-celiac gluten sensitivity / L. Elli, F. Branchi, C. Tomba, D. Villalta, L. Norsa, F. Ferretti, L. Roncoroni, M.T. Bardella. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - 21:23(2015), pp. 7110-7119.
|Titolo:||Diagnosis of gluten related disorders : celiac disease, wheat allergy and non-celiac gluten sensitivity|
ELLI, LUCA (Primo)
BRANCHI, FEDERICA (Secondo)
RONCORONI, LEDA ROSALBA (Penultimo)
BARDELLA, MARIA TERESA (Ultimo)
|Parole Chiave:||Allergy; Celiac disease; Gluten sensitivity; Gluten-free diet; Wheat sensitivity; Adult; Age of Onset; Celiac Disease; Child; Child, Preschool; Food Hypersensitivity; Glutens; Humans; Predictive Value of Tests; Prognosis; Risk Factors; Wheat Hypersensitivity; Diagnostic Techniques, Digestive System; Immunologic Tests; Gastroenterology|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||2015|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.3748/wjg.v21.i23.7110|
|Appare nelle tipologie:||01 - Articolo su periodico|