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

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• 作者：Luca Elli^a ; ^{lucelli@yahoo.com} ; Danilo Villalta^b ; ^{danilo.villalta@aas5.sanita.fvg.it} ; Leda Roncoroni^c ; ^{leda.roncoroni@tiscali.it} ; Donatella Barisani^d ; ^{Donatella.barisani@unimib.it} ; Stefano Ferrero^e ; ^f ; ^{stefano.ferrero@unimi.it} ; Nicoletta Pellegrini^g ; ^{nicoletta.pellegrini@unipr.it} ; Maria Teresa Bardella^a ; Flavio Valiante^h ; ^{flavio.valiante@gmail.com} ; Carolina Tombaⁱ ; ^{tomba.carolina@gmail.com} ; Antonio Carroccio^j ; ^k ; ^{acarroccio@hotmail.com} ; Massimo Bellini^l ; ^{mbellini@med.unipi.it} ; Marco Sonciniⁱ ; Renato Cannizzaro^m ; ^{rcannizzato@cro.it} ; Gioacchino Leandroⁿ ; ^{leandro@media.it}
• 关键词：Celiac disease ; Wheat allergy ; Non-celiac gluten sensitivity ; Gluten-related disorders ; Food allergy
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：49
• 期：2
• 页码：138-146
• 全文大小：1126 K
• 卷排序：49

文摘

“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.AimTo support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood.MethodsThe 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.ResultsThe 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.ConclusionsGluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.