Review of Celiac Disease and Nonceliac Gluten Sensitivity Interview with:

Maureen Leonard, MD MMSc Clinical Director, Center for Celiac Research and Treatment Instructor in Pediatrics, Harvard Medical School Associate Investigator, Nutrition Obesity Research Center, Harvard Medical School MassGeneral Hospital for Children | Pediatric Gastroenterology & Nutrition

Dr. Leonard

Maureen Leonard, MD MMSc
Clinical Director, Center for Celiac Research and Treatment
Instructor in Pediatrics
Associate Investigator, Nutrition Obesity Research Center
Harvard Medical School
Pediatric Gastroenterology & Nutrition
MassGeneral Hospital for Children What is the background for this study? What are the main findings?

Response: In this systematic review, we discuss the clinical approach to celiac disease and nonceliac gluten sensitivity, highlighting how to distinguish between these two conditions and their management. These disorders cannot be distinguished based on symptoms. A single elevated serology test is not diagnostic for celiac disease, and patients with abnormal serologic testing must be referred to a gastroenterologist for further testing and remain on a gluten-containing diet until their diagnostic evaluation is completed. While the treatment for both conditions is a gluten-free diet, the possibility of long-term complications differs. What should readers take away from your report?

Response: Celiac disease and nonceliac gluten sensitivity have heterogenous presentations, and patients with either condition benefit from a gluten-free diet. Clinicians should send an IgA level and IgA tissue transglutaminase test for celiac disease in patients presenting with persistent gastrointestinal or extra-intestinal signs or symptoms. Clinicians should test for celiac disease and consider referral to a gastroenterologist before recommending a gluten-free diet for patients. While routine follow-up should occur with the primary physician, patients diagnosed with celiac disease or nonceliac gluten sensitivity should have an annual exam with a gastroenterologist and dietician.


Leonard MM, Sapone A, Catassi C, Fasano A. Celiac Disease and Nonceliac Gluten SensitivityA ReviewJAMA.2017;318(7):647–656. doi:10.1001/jama.2017.9730

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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