CELIAC DISEASE: CLINICAL EVALUATION AND ENDOCRINOLOGICAL COMPLICATIONS

Abstract

Celiac disease is an autoimmune condition that affects the small intestine of genetically susceptible individuals, caused by permanent intolerance to gluten, a protein present in cereals such as wheat, barley, rye and oats. Celiac disease has an estimated prevalence of 0.3 to 2.4% in the world population, being more common in people of European origin. Treatment consists of excluding gluten from the diet for life, which can represent a challenge for patients and their families. Objective: to evaluate the scientific literature on celiac disease, with an emphasis on its clinical evaluation and its endocrinological complications. Methodology: A search was carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: “celiac disease”, “gluten”, “gluten intolerance”, “endocrinological complications” and “clinical evaluation”. Articles published in the last 10 years (2013-2023), in Portuguese or English, that addressed clinical, diagnostic, therapeutic or prognostic aspects of celiac disease and its endocrinological complications were included. Articles that were not original, that did not have sufficient data or that were not relevant to the topic were excluded. The selected articles were evaluated regarding methodological quality, data extraction and analysis of results. The review followed the recommendations of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Results: 18 articles were selected. The main topics covered by the articles were: The etiology and pathophysiology of celiac disease, involving genetic, immunological and environmental factors, the diagnostic methods of celiac disease, based on clinical, serological, histological and genetic criteria, the treatment of celiac disease, based on in the gluten-free diet and in the nutritional and psychological monitoring of patients, the endocrinological complications of celiac disease, involving osteoporosis, type 1 diabetes mellitus, autoimmune thyroiditis, infertility and growth retardation. Conclusion: Celiac disease is an autoimmune condition that affects the small intestine and can cause several endocrinological complications. The clinical evaluation of celiac disease requires a multidisciplinary approach involving physicians, nutritionists and psychologists. The treatment of celiac disease consists of excluding gluten from the diet for life, which can improve patients' gastrointestinal and extraintestinal symptoms. The systematic review showed that there is scientific evidence about celiac disease and its endocrinological complications, but also highlighted some gaps in the literature that can serve as suggestions for future research.