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Future Trends in the Diagnosis and Management of Celiac Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 24 July 2025 | Viewed by 4730

Special Issue Editors


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Guest Editor
Department of Medicine, Surgery and Dentistry, Medical School of Salerno, 84131 Salerno, Italy
Interests: celiac disease; non-celiac gluten/wheat sensitivity; inflammatory bowel disease; irritable bowel syndrome; nutrition

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Guest Editor
Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, 84081 Salerno, Italy
Interests: celiac disease; inflammatory bowel disease; irritable bowel syndrome; eosinophilic gastrointestinal diseases
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Special Issue Information

Dear Colleagues,

Celiac disease (CeD) is an autoimmune disorder induced by dietary gluten that occurs in genetically predisposed individuals, with a ~1% prevalence in the general population. The clinical picture for the wide spectrum of possible symptoms has changed over the past few decades, from a malabsorptive syndrome of childhood to a disease which can be diagnosed at any age, with chameleon-like manifestations from one person to another.

This Special Issue’s focus is on the future trends in CeD, within which several topics can be addressed, including the following: What are the current clinical features of more recent celiac disease diagnoses? What are the unsolved health issues left after an appropriate gluten-free diet? What about new biomarkers or new approaches to the use of old ones? Also, CeD diagnosis in adults relies on detecting serum gluten-related antibodies in conjunction with intestinal biopsies. However, recent studies have proposed a non-biopsy serological diagnosis of CeD based on detecting high-title tTG IgA. How will this information change the guidelines for adult diagnosis ? At present, the lifelong exclusion of gluten-containing cereals from one’s diet represents the only available therapeutic strategy for celiac disease. However, new therapeutic options, substituting or accompanying a gluten-free diet, are emerging.

This Special Issue aims to provide a comprehensive overview of the recent advances in the diagnosis and management of CeD. We would therefore like to invite all colleagues in this field to contribute reviews or original data to this new SI.

Prof. Dr. Carolina Ciacci
Dr. Antonella Santonicola
Guest Editors

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Keywords

  • celiac disease
  • gluten
  • autoimmune disease
  • extraintestinal manifestations
  • serologic diagnosis
  • gluten-free diet

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Published Papers (3 papers)

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Research

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20 pages, 890 KiB  
Article
Effects of a Gluten-Free Diet on Brain Bioelectrical Activity and Neurological Symptoms in Children with Celiac Disease: A Study Using EEG Assessment
by Milena Zochowska-Sobaniec, Elzbieta Jarocka-Cyrta, Joanna Maria Lotowska and Piotr Sobaniec
J. Clin. Med. 2025, 14(3), 725; https://doi.org/10.3390/jcm14030725 - 23 Jan 2025
Viewed by 1043
Abstract
Celiac disease (CeD), also known as gluten enteropathy, is an immune-mediated inflammatory enteropathy triggered by intolerance to gluten. It presents with a spectrum of symptoms, including both gastrointestinal and extraintestinal manifestations, as well as neurological symptoms. A review of the literature indicates that [...] Read more.
Celiac disease (CeD), also known as gluten enteropathy, is an immune-mediated inflammatory enteropathy triggered by intolerance to gluten. It presents with a spectrum of symptoms, including both gastrointestinal and extraintestinal manifestations, as well as neurological symptoms. A review of the literature indicates that 10–22% of patients with CeD present with neurological symptoms. The objective of this study is to assess the influence of a gluten-free diet (GFD) on brain bioelectrical activity and neurological symptoms in children with CeD. Methods: The study was conducted using a multidisciplinary approach, encompassing a comprehensive array of clinical data gathered alongside laboratory test results, questionnaires, and electroencephalogram (EEG) assessments. The study population included 85 children: 18 newly diagnosed cases of CeD patients (NDC), subsequently reassessed after 6 months on a GFD as a celiac disease on diet (CDD); 27 CeD patients on a GFD for over 12 months (CDD2); and 40 healthy individuals in the comparison group (CG). Results: It was observed that over half of the NDC group exhibited neurological symptoms, particularly headaches. Following a six-month period on a GFD, there was a notable reduction in symptom severity. In comparison to the CG, the NDC patient group exhibited a higher prevalence of abnormalities in EEG recordings (p = 0.032), including focal sharp waves or slow waves. Conclusions: The results demonstrate that a GFD has a positive impact on the neurological condition of children with CeD. The clinical improvements correspond with EEG normalization, which supports the hypothesis that dietary intervention plays a role in mitigating CeD-associated neurological dysfunction. Full article
(This article belongs to the Special Issue Future Trends in the Diagnosis and Management of Celiac Disease)
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Review

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11 pages, 245 KiB  
Review
Gastrointestinal and Hepatobiliary Manifestations Associated with Untreated Celiac Disease in Adults and Children: A Narrative Overview
by Herbert Wieser, Carolina Ciacci, Carlo Soldaini, Carolina Gizzi and Antonella Santonicola
J. Clin. Med. 2024, 13(15), 4579; https://doi.org/10.3390/jcm13154579 - 5 Aug 2024
Cited by 5 | Viewed by 2644
Abstract
Celiac disease (CeD) is a chronic inflammatory disease of the small intestine, produced by ingesting dietary gluten products in susceptible people. Gluten causes an impairment of the mucosal surface and, consequently, an abnormal absorption of nutrients. Although malabsorption of essential nutrients is a [...] Read more.
Celiac disease (CeD) is a chronic inflammatory disease of the small intestine, produced by ingesting dietary gluten products in susceptible people. Gluten causes an impairment of the mucosal surface and, consequently, an abnormal absorption of nutrients. Although malabsorption of essential nutrients is a major risk factor for various CeD-associated morbidities, genetic, immunological, and environmental factors also play an important role. The clinical presentation of CeD widely varies and can range from asymptomatic to full-blown symptoms due to the multi-system nature of CeD. The typical gastrointestinal (GI) manifestations of CeD include abdominal pain, diarrhea, bloating, and weight loss, but several hepatobiliary manifestations and a poor nutritional status have also been described. Currently, a gluten-free diet (GFD) is the only current evidence-based treatment that leads to the complete recovery of mucosal damage and the reversibility of its progression. Conversely, undiagnosed CeD might have severe consequences in children as well as in adult patients. This narrative overview aims to characterize the GI and hepatobiliary manifestations, nutritional deficiencies, and delayed pediatric development associated with unrecognized CeD in order to identify it promptly. Moreover, the role of GFD and how it could prevent long-term complications of CeD are described. Full article
(This article belongs to the Special Issue Future Trends in the Diagnosis and Management of Celiac Disease)

Other

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17 pages, 1536 KiB  
Systematic Review
Prevalence of Joint Complaints in Patients with Celiac Disease: A Systematic Review and Meta-Analysis
by Dimitri Poddighe, Gulsamal Zhubanova, Dinara Galiyeva, Kamilla Mussina and Anders Forss
J. Clin. Med. 2025, 14(11), 3740; https://doi.org/10.3390/jcm14113740 - 27 May 2025
Viewed by 417
Abstract
Background: Current evidence suggests that joint complaints can represent an extra-intestinal manifestation in patients with Celiac Disease (CD) without any rheumatic comorbidity. However, the prevalence of joint complaints in the context of both CD and rheumatic disease is not known. The aim [...] Read more.
Background: Current evidence suggests that joint complaints can represent an extra-intestinal manifestation in patients with Celiac Disease (CD) without any rheumatic comorbidity. However, the prevalence of joint complaints in the context of both CD and rheumatic disease is not known. The aim of this study was to estimate the prevalence of joint complaints in patients with CD. Methods: We searched Medline, Embase, Cochrane, and Web of Science databases for studies reporting joint complaints in patients with CD between 1 January 1990 and 26 November 2024. Search results were screened by two independent reviewers. The pooled prevalence of joint complaints was estimated in meta-analysis using a random effects model. We conducted stratified analyses by region, age (adults vs. children), and study sample size. The Joanna Briggs Institute Critical Appraisal Tool was used to evaluate the quality of included studies, and publication bias was assessed using a funnel plot and Egger’s test. The study protocol was pre-registered in the PROSPERO database and the results were reported according to the PRISMA guidelines. Results: A total of 7414 publications were rendered in the search. Of these, 226 were reviewed in full text and 27 were included in the meta-analysis. Among 6901 patients with CD without any concomitant rheumatic diagnosis, 530 had joint complaints, yielding a weighted pooled prevalence of 10.7% (95%CI: 6.9–15.1). In meta-regression analysis, no association between the prevalence of joint complaints and patients’ clinical characteristics or demographics was found. Conclusions: This meta-analysis indicates that joint complaints in patients with CD without any specific rheumatic comorbidity are not uncommon. Increased awareness of joint complaints in CD is important to improve the diagnosis and clinical care of these patients. Full article
(This article belongs to the Special Issue Future Trends in the Diagnosis and Management of Celiac Disease)
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