cöliákia

Cöliákia, or celiac disease, is a chronic autoimmune enteropathy triggered by gluten in genetically predisposed individuals. Gluten proteins in wheat, barley, and rye provoke an inflammatory response that damages the small intestinal mucosa, causing villous atrophy and malabsorption.

Clinical presentation is variable. In children, symptoms often include chronic diarrhea, abdominal pain, bloating, and poor weight gain. Adults may have non-gastrointestinal symptoms such as iron-deficiency anemia, fatigue, osteoporosis, or dermatitis herpetiformis. Some people are asymptomatic but have positive serology or mucosal changes.

Genetic predisposition usually involves HLA-DQ2 or HLA-DQ8. The disease involves an autoimmune reaction to gluten peptides, leading to villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes, with malabsorption of nutrients including iron and calcium.

Diagnosis combines serology and histology. Testing typically starts with IgA anti-tissue transglutaminase (tTG-IgA) and anti-endomysial antibodies, along with total IgA. If positive or suspicion remains, a duodenal biopsy confirms the diagnosis by showing villous atrophy and other histological changes.

Treatment is lifelong gluten avoidance, excluding wheat, barley, and rye, and careful avoidance of cross-contamination. Nutritional supplementation may be needed to address deficiencies. Regular follow-up assesses symptoms, growth, and laboratory markers; mucosal healing may occur over months to years. With strict adherence, prognosis is generally favorable.