Nomenclature and diagnosis of gluten-related disorders: A position statement by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO)

Pathway
Immunology, Small Intestine & Nutrition

Citation
Digestive and Liver Disease 49 (2017) 138–146; PMID 27887897

Synopsis

Background
“Gluten-related disorders” is a term that encompasses different diseases induced by the ingestion of gluten-containing food. Because of their incidence the scientific community has been intensively studying them.

Aim
To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood.

Methods
The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) commissioned a panel of experts to prepare a position statement clarifying the nomenclature and diagnosis of gluten-related disorders, focusing on those of gastroenterological interest. Each member was assigned a task and levels of evidence/recommendation have been proposed.

Results
The panel identified celiac disease, wheat allergy and non-celiac gluten sensitivity as the gluten-related disorders of gastroenterological interest. Celiac disease has an autoimmune nature, wheat allergy is IgE-mediated while the pathogenesis of non-celiac gluten sensitivity is still unknown as is the case of non-IgE mediated allergy. Diagnosis should start with the serological screening for celiac disease and wheat allergy. In case of normal values, the response to a gluten-free diet should be evaluated and a confirmatory blind food challenge carried out.

Conclusions
Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.
 
Keywords: Celiac disease, wheat allergy, non-celiac gluten sensitivity, gluten-related disorders, food allergy

Available Languages

English

Source File

Publishing organization(s):

ITALY (AIGO) Associazione Italiana Gastroenterologi ed Endoscopisti Digestivi Ospedalieri

Scientific area:

Immunology, Small Intestine & Nutrition
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