Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Figure 1 PRISMA flow diagram.

Figure 2 Recommendations about case finding.

Figure 3 Worldwide adapted decision-making process for diagnosing celiac disease. Highly suspicious celiac disease (CD) comprises “classical presentation” (i.e., classical symptoms in children include failure to thrive, weight loss, growth failure, vomiting, chronic diarrhea, bloating, Iron-deficiency anemia, muscle wasting, oedema due to hypoproteinemia, irritability and unhappiness; in adults, classical symptoms include chronic diarrhea, weight loss, iron-deficiency anemia, malaise and fatigue, oedema due to hypoproteinemia, and osteoporosis), frequent “non-classical presentation” (i.e., iron deficiency and hypertransaminasemia) and “non-classical presentation” but high risk group (i.e., CD first-degree relatives, autoimmune conditions such as type 1 Diabetes Mellitus, and thyroid disease, genetic conditions such as IgA deficiency, Down syndrome, Turner syndrome and Williams-Beuren syndrome).

Figure 4 Recommendations about serology. IgA: Immunoglobulin A; IgG: Immunoglobulin G; DGP: Deamidated gliadin peptides; EMA: Anti-endomysium antibodies.

Figure 5 Recommendations about serology.

Figure 6 Recommendations about Human Leukocyte Antigen testing.

Figure 7 Recommendations about the possibility of a no-biopsy diagnosis. TGA: Anti-transglutaminase antibodies; IgA: Immunoglobulin A; EMA: Anti-endomysium antibodies; HLA: Human leukocytes antigen; CD: Celiac disease.

Figure 8 Recommendations about potential, silent, and seronegative celiac disease. GFD: Gluten-free diet; HLA: Human leukocytes antigen.

Figure 9 Recommendations about refractory and complicated celiac disease. GFD: Gluten-free diet; TCR: T-cell receptor.

Figure 10  Recommendations about follow-up of celiac disease. TGA: Anti-transglutaminase antibodies; GFD: Gluten-free diet.

Figure 11  Recommendations about the gluten-free diet for celiac disease.