Refractory celiac disease: an integrative review
DOI:
https://doi.org/10.62827/nb.v23i1.3002Keywords:
Celiac disease; gluten-free diet; glutens.Abstract
Introduction: celiac disease (CD) is a chronic immune-mediated enteropathy of the small intestine, characterized by specific serological and histological profiles, driven by gluten ingestion by genetically predisposed individuals. The inflammatory process leads to small intestine mucosa villous atrophy. Non-responsive celiac disease (NRCD) is identified by the refered atrophy due to the strict dietary treatment ineffectiveness. The persistence of this condition for more than 12 months defines refractory celiac disease (RCD). Objective: to present the characteristics of RCD. Methods: integrative literature review based on articles indexed in SciELO, BVS and MEDLINE/PubMed electronic databases, published between 2012 and 2022, with the descriptors “refractory celiac disease” and “celiac disease” in Portuguese, English and Spanish. Results: fifteen studies were selected, which described the subtypes, etiology, pathophysiology, epidemiology, signs and symptoms, diagnosis and treatment of RCD. RCD has a multifactorial etiology, resulting from the interaction between environmental, genetic and immunological factors. Pathophysiology is based on immunity and malnutrition is a chronic symptom. The treatment is based on a gluten-free diet in addition to pharmacological therapies. Conclusion: the identification of RCD requires better diagnostic tools. Adjunctive therapies to dietary treatment show unsatisfactory results.
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