Richtlijn ‘Coeliakie en dermatitis herpetiformis’

Guideline ‘Coeliac disease and dermatitis herpetiformis’

Conflict of interest: none declared. Financial support: none declared.

• The Dutch evidence-based guideline ‘Coeliac disease and dermatitis herpetiformis’ contains instructions for detection and treatment of coeliac disease.

• Coeliac disease has a high prevalence: 0.5 - 1.3%.

• The disease has a broad spectrum of symptoms, frequently also outside the gastrointestinal tract.

• Relatives of patients and persons with autoimmune diseases, microscopic colitis, IgA deficiency and syndromes of Down, Turner and Williams have an increased risk of coeliac disease.

• Detection is carried out by determination of IgA antibodies to tissue transglutaminase and endomysium.

• Testing for IgA antibodies to gliadin is only recommended in children younger than 2 years.

• Absence of HLA-DQ2 and DQ8 indicates that coeliac disease is most unlikely.

• The diagnosis should be confirmed by small bowel biopsy.

• Single biopsy following gluten ingestion is sufficient for diagnosis at all ages.

• After the diagnosis, patients should be referred to a dietician. Additionally, a yearly follow-up by a paediatrician or internal medical specialist with appropriate gastroenterology specialisation is recommended.