Luca Elli1, Danilo Villalta2, Leda Roncoroni3, Donatella Barisani4, Stefano Ferrero5, Nicoletta Pellegrini6, Maria Teresa Bardella7, Flavio Valiante8, Carolina Tomba9, Antonio Carroccio10, Massimo Bellini11, Marco Soncini12, Renato Cannizzaro13, Gioacchino Leandro14. 1. Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milano, Italy. Electronic address: lucelli@yahoo.com. 2. Allergology and Clinical Immunology Unit, AO "Santa Maria degli Angeli", via Montereale 24, 33170 Pordenone, Italy. Electronic address: danilo.villalta@aas5.sanita.fvg.it. 3. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy. Electronic address: leda.roncoroni@tiscali.it. 4. Dipartimento di Medicina e Chirurgia (school of Medicine and Surgery) Università Milano Bicocca, Monza, Italy. Electronic address: Donatella.barisani@unimib.it. 5. Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. Electronic address: stefano.ferrero@unimi.it. 6. Department of Food Science, University of Parma, Parma, Italy. Electronic address: nicoletta.pellegrini@unipr.it. 7. Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milano, Italy. 8. Gastroenterology and Digestive Endoscopy Unit, Santa Maria del Prato Hospital, Feltre, Italy. Electronic address: flavio.valiante@gmail.com. 9. Gastroenterology Unit ASST - Santi Paolo e Carlo - Milano, Italy. Electronic address: tomba.carolina@gmail.com. 10. DiBiMIS, University of Palermo, Palermo, Italy; Internal Medicine, Giovanni Paolo II Hospital, Sciacca, Italy. Electronic address: acarroccio@hotmail.com. 11. Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Pisa, Italy. Electronic address: mbellini@med.unipi.it. 12. Gastroenterology Unit ASST - Santi Paolo e Carlo - Milano, Italy. 13. Gastroenterology, CRO National Cancer Institute, via Franco Gallini 2, 33081, Aviano, Italy. Electronic address: rcannizzato@cro.it. 14. Gastroenterology, IRCCS De Bellis Hospital, Castellana Grotte, Italy. Electronic address: leandro@media.it.
Abstract
BACKGROUND: "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. AIM: To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood. METHODS: The 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. RESULTS: The 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. CONCLUSIONS: Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.
BACKGROUND: "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. AIM: To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood. METHODS: The 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. RESULTS: The panel identified celiac disease, wheatallergy and non-celiac gluten sensitivity as the gluten-related disorders of gastroenterological interest. Celiac disease has an autoimmune nature, wheatallergy 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 wheatallergy. In case of normal values, the response to a gluten-free diet should be evaluated and a confirmatory blind food challenge carried out. CONCLUSIONS: Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.
Authors: Deanna L. Kelly; Haley K. Demyanovich; Katrina M. Rodriguez; Daniela Ciháková; Monica V. Talor; Robert P. McMahon; Charles M. Richardson; Gopal Vyas; Heather A. Adams; Sharon M. August; Alessio Fasano; Nicola G. Cascella; Stephanie M. Feldman; Fang Liu; MacKenzie A. Sayer; Megan M. Powell; Heidi J. Wehring; Robert W. Buchanan; James M. Gold; William T. Carpenter; William W. Eaton Journal: J Psychiatry Neurosci Date: 2019-07-01 Impact factor: 6.186
Authors: Antonio Carroccio; Pasquale Mansueto; Maurizio Soresi; Francesca Fayer; Diana Di Liberto; Erika Monguzzi; Marianna Lo Pizzo; Francesco La Blasca; Girolamo Geraci; Alice Pecoraro; Francesco Dieli; Detlef Schuppan Journal: Nutrients Date: 2020-04-17 Impact factor: 5.717