Abstract
Celiac disease is a multi-organ disorder which is highly variable in its clinical expression, presenting multiple enteric and extraintestinal manifestations. However, most of treating physicians and dieticians regard celiac disease as a chronic, gradually evolving, asymptomatic or hypo-symptomatic entity. The present mini-review aims to screen the literature for acute presentations of celiac disease and to increase the awareness of the medical communities, for such a possibility. It appears that the disease can present acutely in multiple symptomatic, phenotypic and laboratory pictures. The acute presentation involves mainly the gastrointestinal tract and adjacentorgans like liver and gallbladder, however, extraintestinal and remote organs presentations can occur.
Highlights
Celiac disease (CD) is an autoimmune disorder elicited in genetically predisposed individuals by the consumption of gluten-containing grains or ingredients of them.It is generally accepted that CD affects approximately 1-1.5% of Western populations, whereby in Northern European countries like Sweden, Finland and Ireland the incidence is higher, fitting the North to South incidence gradient [1]
The present review aims to screenthe literature for acute presentations of CD and to increase the awareness of the medical communities for such a possibility
In view of the routine belief that CD presents mainly in a hypo- or asymptomatic ways, the health providing care teams should be aware of such acute presentations in a chronic disease like CD
Summary
Celiac disease (CD) is an autoimmune disorder elicited in genetically predisposed individuals by the consumption of gluten-containing grains (i.e. wheat, barley, rye and oat) or ingredients of them.It is generally accepted that CD affects approximately 1-1.5% of Western populations, whereby in Northern European countries like Sweden, Finland and Ireland the incidence is higher, fitting the North to South incidence gradient [1]. CD is a multi-organ disorder which is highly variable in its clinical expression, presentingmultiple enteric and extraintestinal manifestations [8] For these reasons the diagnosis is often delayed. We are witnessing an epidemiological shift in the disease phenotype toward a more advanced age, and increased prevalence of latent, hypo-symptomatic or asymptomatic behavior [15]. All these changes make the diagnosis of the disease more difficult and the reliance on symptomatology more remote. Most of treating physicians and dieticians regard CD as a chronic, gradually evolving, unnoticed,asymptomatic or hypo-symptomatic entity In such a case, quite frequently, acute presentations are not considered and do not lead to bring up CD as a possibility. The present review aims to screenthe literature for acute presentations of CD and to increase the awareness of the medical communities for such a possibility
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