Abstract
Celiac disease in Czech population remains diagnosed infrequently and at a late stage. The altered phenotype of the disease is the main cause.
Intestinal symptoms dominate in small children only. Extraintestinal (atypical) symptoms are observed with increased frequency in older children, adolescents and particularly in adults.
Targeted screening program aimed at risk groups and diseases, suspicious symptoms and associated autoimmune diseases represents the most important measure to improve the present situation. The two-step program is recommended in subjects of individual groups.
The first step includes determination of IgA-serum antibodies to tissue transglutaminase (AtTGA-IgA) and total IgA. In isolated IgA deficiency AtTGA-IgG are followed.
Positive serology indicates the second step, i.e. peroral biopsy of small-intestinal (duodenal) mucosa. Important outcomes of this approach include: early diagnosis, therapy and follow-up, recognition of extraintestinal forms, the real prevalence of celiac disease in Czech Republic, prevention of complications, decrease and better control of associated autoimmune diseases, improved quality of life for celiacs as well as savings of health and social insurance payments. transglutaminase serum-autoantibodies, biopsy of intestinal mucosa.