Management of celiac disease: from evidence to clinical practice

  • Tiziana M. Attardo | claudia.fantucchio@alice.it Department of Internal Medicine, Barone Lombardo Hospital, Canicattì (AG), Italy.
  • Elena Magnani Department of Internal Medicine, M. Bufalini Hospital, AUSL Romagna, Cesena (FC), Italy.
  • Carlotta Casati Department of Internal Medicine, Careggi Hospital, Firenze, Italy.
  • Danilo Cavalieri School of Specialization in Internal Medicine, Campus Bio-Medico University, Roma, Italy.
  • Pietro Crispino Department of Internal Medicine and Emergency, Lagonegro Hospital, ASP Potenza, Lagonegro (PZ), Italy.
  • Federica Fascì Spurio Department of Internal Medicine, Dell’Angelo Hospital, Asl 12 Veneziana, Mestre (VE), Italy.
  • Stefano De Carli Department of Internal Medicine, S. Maria della Misericordia Hospital, Udine, Italy.
  • Daniela Tirotta Department of Internal Medicine, Cervesi Hospital, AUSL Romagna, Cattolica (RN), Italy.
  • Paola Gnerre Department of Internal Medicine 2, San Paolo Hospital, Savona, Italy.

Abstract

Celiac disease (CD) is a complex polygenic disorder, which involves genetic factors human leukocyte complex (HLA) and non-HLA genes, environmental factors, innate and adoptive immunity, and a robust chronic T-mediated autoimmune component. The main goal of the present monograph is to define a methodological approach for the disease, characterized by frequent late diagnosis, in order for the physician to become aware of the disease management, the diversity of the clinical presentation itself and in different patients. A unique attention is payed to the specific diagnostic tests to define a correct and accurate application of them, and in addition, to disease follow-up and possible complications. Moreover, a dedicated space is assigned to refractory CD, to potential CD and non-celiac gluten sensitivity. Legislative aspects of the celiac disease in Italy are addressed, too. The celiac disease guidelines and their evaluation by means of Appraisal of Guidelines, Research and Evaluation II instrument allow us to classify the different recommendations and to apply them according to the stakeholders’ involvement, pertinence, methodological accuracy, clarity and publishing independence. Finally, the most current scientific evidence is taken into account to create a complete updated monograph.

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Author Biographies

Tiziana M. Attardo, Department of Internal Medicine, Barone Lombardo Hospital, Canicattì (AG)

MD  - Medicina Interna - Canicattì

Elena Magnani, Department of Internal Medicine, M. Bufalini Hospital, AUSL Romagna, Cesena (FC)
MD - Department of Internal Medicine, M. Bufalini Hospital, Cesena AUSL Romagna
Carlotta Casati, Department of Internal Medicine, Careggi Hospital, Firenze
MD, Department of Internal Medicine, Careggi Hospital, Firenze
Danilo Cavalieri, School of Specialization in Internal Medicine, Campus Bio-Medico University, Roma
MD, School of Specialisation in Medicine Interne,  Campus Bio-Medico -  Roma
Pietro Crispino, Department of Internal Medicine and Emergency, Lagonegro Hospital, ASP Potenza, Lagonegro (PZ)

MD, Department of Internal Medicine and Emergency, Di Lagonegro Hospital (PZ), ASP Potenza

Federica Fascì Spurio, Department of Internal Medicine, Dell’Angelo Hospital, Asl 12 Veneziana, Mestre (VE)

MD, Department of Internal Medicine, Dell'Angelo Hospital di Mestre, Asl 12 Veneziana 

Stefano De Carli, Department of Internal Medicine, S. Maria della Misericordia Hospital, Udine
MD, SOC 2^ Department of Internal Medicine, S. Maria della Misericordia Hospital, ASUI di Udine
Daniela Tirotta, Department of Internal Medicine, Cervesi Hospital, AUSL Romagna, Cattolica (RN)

MD, Department of Internal Medicine, Cervesi Hospital, Cattolica (RN), AUSL Romagna

Paola Gnerre, Department of Internal Medicine 2, San Paolo Hospital, Savona

MD, Department of Internal Medicine  2, San Paolo Hospital,  Savona.

 

Published
2017-11-28
Info
Issue
Section
Reviews
Keywords:
Celiac disease, guidelines, potential and refractory celiac disease, non-celiac gluten sensitivity, Italian legislative aspects of celiac disease.
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How to Cite
Attardo, T. M., Magnani, E., Casati, C., Cavalieri, D., Crispino, P., Fascì Spurio, F., De Carli, S., Tirotta, D., & Gnerre, P. (2017). Management of celiac disease: from evidence to clinical practice. Italian Journal of Medicine, 11(4), 345-359. https://doi.org/10.4081/itjm.2017.821

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