PMID- 20670718
OWN - NLM
STAT- MEDLINE
DCOM- 20100831
LR  - 20220318
IS  - 1555-7162 (Electronic)
IS  - 0002-9343 (Linking)
VI  - 123
IP  - 8
DP  - 2010 Aug
TI  - Celiac disease diagnosis: simple rules are better than complicated algorithms.
PG  - 691-3
LID - 10.1016/j.amjmed.2010.02.019 [doi]
AB  - Celiac disease is the only treatable autoimmune disease, provided that a correct 
      diagnosis is achieved and a strict, lifelong gluten-free diet is implemented. The 
      current diagnostic algorithm for celiac disease includes initial screening 
      serological tests, followed by a confirmatory small intestinal biopsy showing the 
      autoimmune insult typical of celiac disease. The biopsy, considered the 
      diagnostic gold standard, has been recently questioned as a reliable and 
      conclusive test for every case. Indeed, the wide variability of celiac 
      disease-related findings suggests that it is difficult to conceptualize the 
      diagnostic process into rigid algorithms that do not always cover the clinical 
      complexity of this disease. Instead we find clinically useful the shifting to a 
      quantitative approach that can be defined as the "4 out of 5" rule: the diagnosis 
      of celiac disease is confirmed if at least 4 of the following 5 criteria are 
      satisfied: typical symptoms of celiac disease; positivity of serum celiac disease 
      immunoglobulin, A class autoantibodies at high titer; human leukocyte antigen 
      (HLA)-DQ2 or DQ8 genotypes; celiac enteropathy at the small bowel biopsy; and 
      response to the gluten-free diet.
CI  - Copyright 2010 Elsevier Inc. All rights reserved.
FAU - Catassi, Carlo
AU  - Catassi C
AD  - Mucosal Biology Research and Center for Celiac Research, University of Maryland, 
      School of Medicine, Baltimore, MD 21201, USA.
FAU - Fasano, Alessio
AU  - Fasano A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Algorithms
MH  - Autoantibodies/analysis
MH  - Celiac Disease/*diagnosis/genetics/immunology/pathology
MH  - HLA Antigens/analysis
MH  - Humans
MH  - Intestinal Mucosa/pathology
EDAT- 2010/07/31 06:00
MHDA- 2010/09/02 06:00
CRDT- 2010/07/31 06:00
PHST- 2010/02/10 00:00 [received]
PHST- 2010/02/17 00:00 [revised]
PHST- 2010/02/19 00:00 [accepted]
PHST- 2010/07/31 06:00 [entrez]
PHST- 2010/07/31 06:00 [pubmed]
PHST- 2010/09/02 06:00 [medline]
AID - S0002-9343(10)00359-1 [pii]
AID - 10.1016/j.amjmed.2010.02.019 [doi]
PST - ppublish
SO  - Am J Med. 2010 Aug;123(8):691-3. doi: 10.1016/j.amjmed.2010.02.019.