Keliakiaa

Keliakiaa, also known as celiac disease, is a chronic autoimmune disorder in which ingestion of gluten triggers an immune response that damages the lining of the small intestine in people who are genetically predisposed. Gluten, a group of proteins found in wheat, barley, and rye, can also cause symptoms in some individuals when present in contaminated or processed foods.

In affected individuals, the immune reaction leads to inflammation and injury to the intestinal mucosa, notably causing villous atrophy and crypt hyperplasia. This damage reduces the intestine’s ability to absorb nutrients, which can result in a range of gastrointestinal and systemic symptoms. Common signs in children include chronic diarrhea, abdominal pain, weight loss, and growth lag, while adults may experience bloating, iron-deficiency anemia, fatigue, and dermatitis herpetiformis. Extraintestinal manifestations such as osteoporosis, infertility, and neuropathy can occur.

Diagnosis typically involves serologic testing for specific antibodies, such as tissue transglutaminase IgA (tTG-IgA), along with measurement of total IgA. Genetic testing for HLA-DQ2 or HLA-DQ8 haplotypes can support the assessment but is not diagnostic on its own. A confirmatory small intestine biopsy showing villous atrophy is often performed, especially when serology is inconclusive.

The primary treatment is a lifelong strict gluten-free diet, which allows intestinal healing and symptom relief in most patients. Careful avoidance of cross-contamination is important, and nutritional supplementation may be needed to address deficiencies. With adherence, the prognosis is generally favorable, though monitoring for associated autoimmune conditions and complications is recommended. Globally, keliakiaa affects about 1% of people, with higher prevalence in individuals with other autoimmune diseases.