Celiac disease - from screening to diagnosis

Celiac disease is poorly diagnosed in Czech population, mostly after a long duration of the disease. Undiagnosed celiac disease often

leads to the development of osteoporosis, autoimmune disorders and malignant diseases. People with celiac disease, where the disease

hasn´t been diagnosed, have almost four times increased mortality compared to serum negative persons. The introduction of targeted

screening is an essential step to limiting the negative consequences of unrecognized disease. The persons indicated for celiac disease

screening a quantitative test for antibodies against tissue transglutaminase and total IgA is performed. A pathological value of the test

indicates the performance of gastroscopy with a biopsy of the aboral duodenum mucosa. After the histological examination using the

Marsh classification, the following steps can be taken: testing antibodies against endomysium; differential diagnosis of excluding any

disease mimicking celiac disease; genetic testing and confirmation of diagnosis using a positive clinical and serological response to

a gluten – free diet.

histology, genetics.

Keywords: celiac disease, target screening, clinical forms of celiac disease, antibodies against tissue transglutaminase and endomysium,