DISEASES OF THE SMALL INTESTINE. PART 4. CELIAC DISEASE AND OTHER DISORDERS ASSOCIATED WITH GLUTEN

In the fourth part of our literary review devoted to diseases of the small intestine, information is provided about celiac disease, i.e. about "suffering from intestinal disorder" (translated from Greek). According to the classification, autoimmune and allergic conditions associated with gluten, as well as non-celiac gluten sensitivity are considered. The modern possibilities of diagnosis and differential diagnosis of these disorders are presented. Gluten itself, an important fraction of wheat, rye and barley, is characterized. Accurate diagnosis of celiac disease at the present stage is the possibility of conducting second–order tests to detect antibodies to deaminated gliadin peptides, antibodies to endomysium and its main antigen – the enzyme tissue transglutaminase. Histological changes by stages, the role of HLA-DQ2/DQ8 in the pathogenesis of celiac disease are presented. The basis of treatment is compliance with an elimination diet. Further described are herpetiform dermatitis, gluten ataxia, variants of wheat allergy, which includes more than three hundred proteins, thirty of them are recognized as allergenic. Modern tests for determining specific IgE, available for prescribing and detecting allergens. Non–celiac sensitivity (NCCHG) to gluten is the diagnosis of exclusion. NCCHG triggers. Solerno criteria. Risk groups for celiac disease.