Diagnostics

The clinical picture of celiac disease varies widely; the onset of the disease can occur at any age:

the first peak of manifestation is in the first 2 years of life, shortly after cessation of breastfeeding and the introduction of gluten-containing products,
the second peak is in the second or third decade of life.

ПОТЕНЦИАЛЬНАЯ

Over the past 10 years, attempts have been made to reach a consensus on the terminology of the clinical stages of celiac disease. Thus, the main forms of clinical manifestations of the disease were published in the Lancet journal:

АСИМПТОМАТИЧЕСКАЯ

СИМПТОМАТИЧЕСКАЯ

КЛАССИЧЕСКАЯ

НЕКЛАССИЧЕСКАЯ

РЕФРАКТЕРНАЯ

potential: positive serological tests in the absence of symptoms and a normal intestinal biopsy. The term "potential" is also used in individuals who have never been diagnosed with celiac disease but have a corresponding genetic background (HLA-DQ2/DQ8);

asymptomatic: absence of symptoms against the background of positive serological tests and the corresponding histological picture;

symptomatic: the presence of both intestinal and extraintestinal symptoms;

non-classical: intestinal (abdominal pain, flatulence, constipation) or extraintestinal (iron deficiency, chronic fatigue, headache, osteopenia/osteoporosis, neurological disorders) manifestation of the disease;

refractory: the presence of symptoms of celiac enteropathy and intestinal villous atrophy that persist for 1 year after following a strict gluten-free diet

classic: presence of symptoms of malabsorption: diarrhea, steatorrhea, weight loss, developmental delay, presence/absence of anemia;

Diagnosing celiac disease is a complex process, as symptoms of the disease can vary significantly from patient to patient, and cases of late diagnosis still occur today.

Clinical protocols for the diagnosis and treatment of celiac disease in the Republic of Kazakhstan

The following have been approved and are in force in Kazakhstan:

- clinical protocol for diagnosis and treatment “Celiac disease in children”, approved by the Minutes of the meeting of the expert commission on healthcare development of the Ministry of Health of the Republic of Kazakhstan dated November 30, 2015. N 18

- clinical protocol for diagnosis and treatment “Celiac disease (celiac enteropathy) in adults”, approved by protocol N 107 by the joint commission on the quality of medical services of the Ministry of Health of the Republic of Kazakhstan dated July 16, 2020.