Extraintestinal Manifestations and Associated Diseases

Luis Rodrigo Saez, Mª Eugenia Lauret-Braña, I. Pérez-Martínez


Celiac disease (CD) is frequently accompanied by a variety of extra-digestive manifestations, thus making it a systemic disease, rather than a disease limited to the gastrointestinal tract. This is primarily explained by the fact that CD belongs to the autoimmune disease group, the only one with a known etiology, related to a permanent gluten intolerance. Remarkable breakthroughs have been achieved in the last decades, due to a greater interest in the diagnosis of atypical and asymptomatic patients, which are more frequent in adults. The known presence of several associated diseases provide guidance in the search of oligosymptomatic cases as well as studies performed in relatives of CD patients. The causes for the onset and manifestation of associated diseases are diverse: some share susceptibility genes, like type 1 diabetes mellitus (T1DM); others share pathogenetic mechanisms and yet others are of an unknown nature. General practitioners and other specialists must remember that CD may debut with extraintestinal manifestations and associated illnesses may appear both at the time of diagnosis and throughout the evolution of the disease. The implementation of a gluten-free diet (GFD) improves the overall clinical development and the evolution of associated diseases. In some cases, such as in iron deficiency anemia, the GFD contributes to its disappearance. In other diseases, like T1DM, it helps to reduce the amount of insulin needed, thus allowing for a better control of the disease. In several other complications and/or associated diseases, an adequate adherence to a GFD may slow down their evolution, especially if it is implemented during an early stage.

Palabras clave

celiac, extrainstestinal manifestations

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