Celiac vs. Coeliac Disease: Same Condition, Different Spelling
"Celiac disease" (US) and "coeliac disease" (UK, Europe, Commonwealth) are identical. Both refer to an immune-mediated enteropathy triggered by gluten (wheat, barley, rye) in genetically susceptible individuals (HLA-DQ2/DQ8).
Pathophysiology
- Gluten peptides (gliadin) deamidated by tissue transglutaminase (tTG).
- Presented by HLA-DQ2/DQ8 → CD4⁺ T cell activation → intraepithelial lymphocyte infiltration, villous atrophy, crypt hyperplasia.
- Malabsorption: iron, folate, B12, fat-soluble vitamins, calcium.
Diagnosis
- Serology: tTG-IgA (primary), total IgA, DGP-IgA/IgG, EMA-IgA.
- Duodenal biopsies (Marsh classification) — gold standard.
- Must be on gluten-containing diet at testing.
Treatment
- Strict lifelong gluten-free diet (GFD) — only effective therapy.
- Follow-up: serology normalization, symptom resolution, mucosal healing.
- Complications if untreated: lymphoma, osteoporosis, infertility, neuropathy, refractory sprue.
Spelling differs; disease, diagnosis, and management are the same worldwide.
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