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World J Clin Cases. Mar 16, 2015; 3(3): 275-284
Published online Mar 16, 2015. doi: 10.12998/wjcc.v3.i3.275
Clinical and diagnostic aspects of gluten related disorders
Francesco Tovoli, Chiara Masi, Elena Guidetti, Giulia Negrini, Paola Paterini, Luigi Bolondi
Francesco Tovoli, Chiara Masi, Elena Guidetti, Giulia Negrini, Paola Paterini, Luigi Bolondi, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Author contributions: Masi C analyzed the literature about non-celiac-gluten sensitivity and gluten ataxia revising the other sections; Guidetti E gathered the data about celiac disease revising the other sections; Negrini G analyzed trends in gluten related disorders in general with particular detail to non-celiac gluten sensitivity and revised celiac disease section; Paterini P analyzed current laboratory techniques used for the differential diagnosis of gluten-related diseases revising all of the sections; Tovoli F wrote the draft as a whole armonizing the various sections and updating bibliography; Bolondi L revised the final draft; all of the authors have seen and approve the final version of this paper.
Conflict-of-interest: None to declare by any author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Francesco Tovoli, MD, Department of Medical and Surgical Sciences, University of Bologna, via Massarenti 9, 40138 Bologna, Italy. francesco.tovoli2@unibo.it
Telephone: +39-051-2142542 Fax: +39-051-2142260
Received: July 28, 2014
Peer-review started: July 30, 2014
First decision: September 30, 2014
Revised: November 29, 2014
Accepted: December 16, 2014
Article in press: December 19, 2014
Published online: March 16, 2015
Abstract

Gluten is one of the most abundant and widely distributed components of food in many areas. It can be included in wheat, barley, rye, and grains such as oats, barley, spelt, kamut, and triticale. Gluten-containing grains are widely consumed; in particular, wheat is one of the world’s primary sources of food, providing up to 50% of the caloric intake in both industrialized and developing countries. Until two decades ago, celiac disease (CD) and other gluten-related disorders were believed to be exceedingly rare outside of Europe and were relatively ignored by health professionals and the global media. In recent years, however, the discovery of important diagnostic and pathogenic milestones led CD from obscurity to global prominence. In addition, interestingly, people feeding themselves with gluten-free products greatly outnumber patients affected by CD, fuelling a global consumption of gluten-free foods with approximately $2.5 billion in United States sales each year. The acknowledgment of other medical conditions related to gluten that has arisen as health problems, providing a wide spectrum of gluten-related disorders. In February 2011, a new nomenclature for gluten-related disorders was created at a consensus conference in London. In this review, we analyse innovations in the field of research that emerged after the creation of the new classification, with particular attention to the new European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for CD and the most recent research about non-celiac gluten sensitivity.

Keywords: Celiac disease, Wheat allergy, Gluten sensitivity, Non-celiac gluten sensitivity, Gluten-free diet, Gluten, Anti-gliadin antibodies

Core tip: In recent years, there has been a widespread diffusion of gluten-associated symptoms. Current reactions to gluten include, but are not restricted to, celiac disease. This review analyses this interesting epidemiological worldwide phenomenon by discussing the spectrum of gluten-related disorders and focusing on their clinical features and diagnostic criteria. In particular, this paper will cover the most important news from European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for celiac disease and the state of the art of non-celiac gluten sensitivity.