Maladie coeliaque de l’adulte

Abstract

The celiaque disease is an autoimmune chronic inflammatory enteropathy caused by a food antigen the gliadin of gluten. The diagnosis of the disease is based on clinical, serological and histological features. The clinical forms are very variable. The most common signs are abdominal pain, chronic diarrhea, weight loss, bone diseases, anemia and asthaenia. Serologically, antiendomysium antibodies and antitransglutaminase antibodies allow, when they are positive, to confirm the clinical suspicion and to decide on a biopsy of small intestine. Histologically, biopsies of small intestine are indicated when the serological tests are positive. They alone can confirm the diagnosis. In The adult, they are necessarilly performed before a gluten-free diet (GFD). In childhood, biopsy is discussed because of the risks associated with general anesthesia. In the adult, the treatment is based on a GFD all life long. In childhood, the GFD can be interrupted after puberty. The observance of treatment is evaluated by the research of antibodies having served for the diagnosis.