Auteur Topic: Ned.onderzoek> Curr. meth. to diagnose the unresp. and compli. forms Coeliac  (gelezen 1420 keer)


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Dit is een revieuw artikel (totaal 8 pagina's) geplaatst in the European Journal of Medicine.

Het artikel is afkomstig van:
M. Hadithi - Department of Gastroenterology, Maasstad Hospital, Postbus 9119, 3007 AC Rotterdam, The Netherlands
A.S. Peña - Laboratory of Immunogenetics, Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands

Accepted 29 January 2010
Available online 26 February 2010

Fig. 1. Proposed algorithm to diagnose coeliac disease
Fig. 2. Proposed algorithm to diagnose refractory and complicated forms of coeliac disease.

Coeliac disease is a common disorder.
Due to the protean manifestations of the disease and the often mild but indolent course, the diagnosis is often missed.
The method to diagnose this in principle reversible disease after the introduction of a gluten-free diet has attracted the attention of several scientific disciplines to find the simplest and most patient-friendly test.
This has resulted in a noticeable impact on the clinical practice next to a general increased awareness of its existence, its pathogenesis, its course and recent evidence of increased mortality.

Amendments made in the diagnostic criteria of coeliac disease over the last half century have simplified the diagnosis.
However, the aspect most relevant to the specialist in internal medicine is related to its grave consequences when the disease fails to respond to a gluten-free diet.
These refractory cases may culminate in severe complications with sombre endings and malignancy.
Fortunately, current technology can offer the specialist in internal medicine more facilities to diagnose the cause of the complicated cases in order to
attempt to intervene in the course of disease and hopefully save these patients.

We review the available tools that now exist and their indications that can be practiced in a modern clinical setting for the diagnosis of the complicated forms of this disease.

© 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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