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ISSN 1561-3119 (Electronic)

2019, Number 2

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Rev Cubana Pediatr 2019; 91 (2)

Non-celiac Gluten sensitivity

Castañeda GC

Language: Spanish
References: 42
Page: 1-14
PDF size: 172.86 Kb.


ABSTRACT

Introduction: Non-celiac gluten sensitivity (SGNC, by its acronyms in Spanish) is an emerging condition of the last decade, which is mediated by immune mechanisms without a recognized serological marker.
Objective: To update knowledge on SGNC, its pathogenesis, diagnostic and treatment.
Methods: Publications in Spanish and English were reviewed in Google scholar, PubMed, SciELO and Latindex databases from 2014 to August 20, 2018.
Results: Information about the description of SGNC as a non-allergic or autoimmune condition and impact on children and adults is updated. Epidemiology is not established, although recent studies report that it varies between 6 to 10%, with predominance of female / male 3:1. The criteria for the pathogenesis related to the prolamines of toxic cereals, fermentable short chain carbohydrates (FODMAPs) and amylase and trypsin inhibitors are reviewed. The clinical symptoms (intestinal and extraintestinal) were evaluated and it was analyzed the argument established for the diagnosis of certainty and differential with other diseases triggered by gluten, especially celiac disease. The gluten-free diet represents the only treatment option. The symptoms disappear with gluten suppression and reappear when re-introducing it.
Final Considerations: SGNC is a new entity mediated by an immune mechanism with pathogenesis supported by different mechanisms with intestinal and extra intestinal symptoms related to gluten consumption. The diagnosis should not be by exclusion of foods that contain gluten, but by clinical evaluation since there is not serological diagnosis. To know better on it is of interest due to other conditions, such as celiac disease, gluten allergy, irritable bowel syndrome and lymphocytic enteritis, which should be made by differential diagnosis.


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