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
ARTICLE HIGHLIGHTS
Research background

Celiac disease (CD) has risen from obscurity to global prominence in a few decades. These modifications have prompted experts from all over the world to identify effective strategies for the diagnosis and follow-up of CD. Different scientific societies, mainly from Europe and America regions, have proposed different guidelines.

Research motivation

CD guidelines are consistent when they deal key points in the diagnosis and follow-up of this condition. However, they differ in a number of other points.

Research objectives

To identify all of the existing guidelines across the globe and perform a comparative analysis to verify similarities and differences and, thus, discuss the most debated topics and the possible innovations in the next future.

Research methods

We searched PubMed for a complex string containing the terms “celiac disease”, “management”, and “guidelines”. The results were subsequently explored to identify the most recent versions of existing guidelines of governmental agencies and scientific societies. The recommendations provided by each selected guideline were systematically explored and classified under five categories: Patients to be tested for CD, diagnostic tests (serology, duodenal biopsy, genetic test, no-biopsy diagnosis), potential/silent/seronegative CD, refractory/complicated CD, follow-up.

Research results

We identified 7 different guidelines [European Society Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2020; European Society for the Study of Coeliac Disease (ECD) 2019; World Gastroenterology Organization (WGO) 2017; Central Research Institute of Gastroenterology, Russia, 2016; National Institute for Health and Care Excellence (NICE), 2015; British Society of Gastroenterology (BSG), 2014; and America College of Gastroenterology (ACG), 2013]. These guidelines were mostly concordant but differed under certain recommendation for no-biopsy diagnosis, refractory CD, and follow-up.

Research conclusions

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.

Research perspectives

Modifications of the current guidelines are expected in the near future. These modification will probably regard the possibility of a no-biopsy diagnosis (especially in developing countries) and the modalities of follow-up.