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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 637187, 9 pages
http://dx.doi.org/10.1155/2012/637187
Review Article

Atypical Celiac Disease: From Recognizing to Managing

1Laboratory of Immunology, Faculty of Medicine and University Hospital Center, BP 7010, Sidi Abbad, Marrakech, Morocco
2Laboratory of Research “PCIM”, Faculty of Medicine, University Cadi Ayyad, Marrakech, Morocco
3Service of Internal Medicine, University Hospital Center, Marrakech, Morocco
4Service of Gastroenterology, University Hospital Center, Marrakech, Morocco
5Service of Peadiatrics, University Hospital Center, Marrakech, Morocco
6Laboratory of Biochemistry, University Hospital Center, Marrakech, Morocco
7Laboratory of Histopathology, University Hospital Center, Marrakech, Morocco

Received 8 January 2012; Accepted 8 May 2012

Academic Editor: Govind K. Makharia

Copyright © 2012 B. Admou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The nonclassic clinical presentation of celiac disease (CD) becomes increasingly common in physician’s daily practice, which requires an awareness of its many clinical faces with atypical, silent, and latent forms. Besides the common genetic background (HLA DQ2/DQ8) of the disease, other non-HLA genes are now notably reported with a probable association to atypical forms. The availability of high-sensitive and specific serologic tests such as antitissue transglutuminase, antiendomysium, and more recent antideamidated, gliadin peptide antibodies permits to efficiently uncover a large portion of the submerged CD iceberg, including individuals having conditions associated with a high risk of developing CD (type 1 diabetes, autoimmune diseases, Down syndrome, family history of CD, etc.), biologic abnormalities (iron deficiency anemia, abnormal transaminase levels, etc.), and extraintestinal symptoms (short stature, neuropsychiatric disorders, alopecia, dental enamel hypoplasia, recurrent aphtous stomatitis, etc.). Despite the therapeutic alternatives currently in developing, the strict adherence to a GFD remains the only effective and safe therapy for CD.