CELIAC DISEASE: NEW POSSIBILITIES FOR DIAGNOSIS AND MANAGEMENT

Abstract

Вackground. Celiac disease is an autoimmune disease that occurs in genetically predisposed individuals and is characterized by damage to the mucous membrane of the small intestine due to exposure to gluten. The interest of researchers in gluten-associated diseases is growing every year. The true prevalence of celiac disease is not sufficiently studied due to the rarity of "classic" cases and the higher frequency of atypical and various clinical manifestations of this disease. Manifestation of celiac disease is possible at any age, the disease is more often diagnosed in adults. All this dictates the need to develop new algorithms for examining patients for timely detection and treatment of сеliacia. Aim: To review updated key consensus documents on the diagnosis and treatment of celiac disease. Matherials and methods. The results of scientific research related to celiac disease were searched. The studies that are included were selected based on searches in the online databases PubMed, Web of Science, Scopus, Google Scholar and others and relate to the basic methods of diagnosis and management of celiac disease. 110 sources were selected for analysis, of which were used that met the search criteria. Results. Based on the analysis of experimental and clinical studies, difficulties were identified in diagnosing celiac disease associated with a greater prevalence of extraintestinal manifestations and a rarity of "classical" cases. Methods of approach to the diagnosis of celiac disease in children and adults have been developed, taking into account invasiveness and accessibility. The basic approach in the treatment of celiac disease is a observed gluten-free diet. Regarding the selection of products, the individual characteristics of each patient are taken into account. Conclusion. To verify the diagnosis, adults and children with suspected celiac disease are recommended to perform esophagogastroduodenoscopy with biopsy of the duodenal mucosa at several points. An alternative method of diagnosis can be a combination of a very high level of antibodies of the imonoglobulin (Ig) A class to tissue transglutaminase (TGAs) and positive antibodies to endomysium (anti EMA) in two blood samples, however, no single analysis is 100% specific for celiac disease, and the diagnostic accuracy varies significantly between different laboratories. The only proven effective treatment for celiac disease is a lifelong gluten-free diet. In the absence of a complete clinical and serological response to diet, treatment goals are determined individually for each patient. The development of new treatments for celiac disease continues.