celiakia

Celíakia, the Romanian term for celiac disease, is an autoimmune disorder in which ingestion of gluten leads to immune-mediated damage of the small intestine in people with hereditary susceptibility. The disease affects about 1% of the population worldwide, with higher prevalence in those with first-degree relatives with celiac disease and in individuals with other autoimmune conditions. Gluten proteins in wheat, barley, and rye trigger the response.

Symptoms vary and can be intestinal or extraintestinal. In children: failure to thrive, short stature, abdominal pain, chronic diarrhea. In adults: chronic diarrhea, bloating, iron-deficiency anemia, fatigue, weight loss. Dermatitis herpetiformis is a skin manifestation.

Diagnosis involves serologic testing (tTG-IgA, EMA) with consideration of total IgA; genetic testing for HLA-DQ2/DQ8; confirmation by small intestinal biopsy showing villous atrophy and crypt hyperplasia. A gluten-containing diet is typically needed for accurate testing, except with selective IgA deficiency.

Treatment is lifelong strict gluten-free diet; avoidance to allow healing; may require nutritional supplements; monitor growth in children; cross-contamination avoidance. Prognosis improves with treatment; untreated disease can lead to nutritional deficiencies and increased risk of complications such as osteoporosis, infertility, and enteropathy-associated T-cell lymphoma.