Adult coeliac disease

doi:10.1136/bmj.39316.442338.AD

BMJ 2007;335:558-562 (15 September), doi:10.1136/bmj.39316.442338.AD

Clinical Review

Clinical review

Adult coeliac disease

Andrew D Hopper, gastroenterology specialist registrar¹, Marios Hadjivassiliou, consultant neurologist², Sohail Butt, general practitioner³, David S Sanders, consultant gastroenterologist¹

¹ Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield S10 2JF, ² Department of Neurology, Royal Hallamshire Hospital, ³ Studholme Medical Centre, Ashford TW15 2TU

Correspondence to: A D Hopper, Room P39, P Floor, Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield S10 2JF. andydhopper@aol.com

The first 150 words of the full text of this article appear below.

• The prevalence of coeliac disease is0.5-1% in international population studies

• A combinationof tissue transglutaminase antibody, endomysial antibody, andimmunoglobulin A should be used for initial testing

•Antibody negative coeliac disease with villous atrophy is nowrecognised

• Treatment should involve a gluten-free diet,with support from a dietitian and a gastroenterologist

The prevalence of coeliac disease is 0.5-1% in internationalpopulation studies. The delay in diagnosis is reported to rangefrom 4.5 years to 9.0 years.¹ ² Patients may present on numerousoccasions to both primary and secondary care without coeliacdisease being considered.³ Currently, for every adult patientin whom the disease is diagnosed, eight cases are estimatedto go undetected.⁴

Coeliac disease (or gluten sensitive enteropathy) is definedas a state of heightened immunological responsiveness to ingestedgluten (from wheat, barley, or rye) in genetically susceptibleindividuals. Coeliac disease has historically been consideredto . . . [Full text of this article]

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