Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2022; 28(1): 154-175
Published online Jan 7, 2022. doi: 10.3748/wjg.v28.i1.154
Current guidelines for the management of celiac disease: A systematic review with comparative analysis
Alberto Raiteri, Alessandro Granito, Alice Giamperoli, Teresa Catenaro, Giulia Negrini, Francesco Tovoli
Alberto Raiteri, Alessandro Granito, Alice Giamperoli, Teresa Catenaro, Giulia Negrini, Francesco Tovoli, Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
Author contributions: Raiteri A and Tovoli F designed the research; Granito A, and Catenaro T performed the research; Raiteri A, Giamperoli A and Negrini G analysed the data; Raiteri A and Tovoli F wrote the paper.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francesco Tovoli, MD, Assistant Professor, Research Fellow, Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, Bologna 40138, Italy. francesco.tovoli2@unibo.it
Received: March 2, 2021
Peer-review started: March 2, 2021
First decision: July 14, 2021
Revised: August 8, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: January 7, 2022
Processing time: 303 Days and 16.8 Hours
Abstract
BACKGROUND

Wheat and other gluten-containing grains are widely consumed, providing approximately 50% of the caloric intake in both industrialised and developing countries. The widespread diffusion of gluten-containing diets has rapidly led to a sharp increase in celiac disease prevalence. This condition was thought to be very rare outside Europe and relatively ignored by health professionals and the global media. However, in recent years, the discovery of important diagnostic and pathogenic milestones has led to the emergence of celiac disease (CD) from obscurity to global prominence. These modifications have prompted experts worldwide to identify effective strategies for the diagnosis and follow-up of CD. Different scientific societies, mainly from Europe and America, have proposed guidelines based on CD's most recent evidence.

AIM

To identify the most recent scientific guidelines on CD, aiming to find and critically analyse the main differences.

METHODS

We performed a database search on PubMed selecting papers published between January 2010 and January 2021 in the English language. PubMed was lastly accessed on 1 March 2021.

RESULTS

We distinguished guidelines from 7 different scientific societies whose reputation is worldwide recognized and representative of the clinical practice in different geographical regions. Differences were noted in the possibility of a no-biopsy diagnosis, HLA testing, follow-up protocols, and procedures.

CONCLUSION

We found a relatively high concordance between the guidelines for CD. Important modifications have occurred in the last years, especially about the possibility of a no-biopsy diagnosis in children. Other modifications are expected in the next future and will probably involve the extension of the non-invasive diagnosis to the adult population and the follow-up modalities.

Keywords: Celiac disease; Gluten; Gluten-free diet; Gluten sensitivity; Clinical guidelines; Non-invasive diagnosis; Histopathological findings; Serological markers; Genetics

Core Tip: Once considered a rare condition, celiac disease (CD) is becoming a significant health issue globally. An increasing number of studies have investigated this condition. International scientific societies have proposed guidelines for the management of CD to translate this evidence into clinical practice. In this review, we critically analyse both the converging and diverging points in the current clinical guidelines of CD, focusing on the diagnostic aspects and follow-up procedures.