Coeliac disease

Current Care Summary
Working group appointed by the Finnish Medical Society Duodecim and the Finnish Society of Gastroenterology
18.12.2018

Current Care Guideline «Keliakia»1 and Summary «Keliakia»2 in Finnish

Positive endomysium antibodies (EmA) and high concentrations of tissue transglutaminase antibodies (tTG) have excellent accuracy for coeliac disease. The updated guideline recommends using tTG as the first-line diagnostic investigation. Diagnosis can be made without endoscopy in subjects with tTG >10x upper limit of normal and positive EmA; in other cases intestinal biopsy is needed. Skin biopsy is required for the diagnosis of dermatitis herpetiformis. The treatment is a life-long gluten-free diet initiated under the supervision of a dietitian. The possibility of refractory coeliac disease should be remembered particularly in older persons and in those with inadequate dietary response.

Katri Kaukinen (Chair)

Kalle Kurppa

Ursula Schwab

Kaisa Hervonen

Kaija-Leena Kolho

Sari Anthoni

Katriina Kukkonen-Harjula

Consultant:

Jorma Komulainen