FacebookIn principle follow-up examinations are recommended 3-4 months and 1 year after the diagnosis. After that, the following examinations are recommended once a year (life-long):
- Clinical examination: weight, height, BMI, with children puberty status, general wellbeing
- Laboratory tests should evaluate the presence of micronutrients malabsorption, including complete blood count, iron status, folate, vitamin B12, calcium, phosphate, vitamin D, and should monitor associated autoimmune conditions (thyroid-stimulating hormone and serum glucose) and liver disorders (aspartate aminotransferase/alanine aminotransferase). Should a noticeable weight gain be asserted during check-ups we recommend to do first degree metabolic examinations (total cholesterol, HDL cholesterol, triglycerides, glucose).
- Dietary review
- Biopsy check-up is needed in those with persistent symptoms despite adopting a strict GFD or in patients who develop additional red flag symptoms. It seems wise to do a follow-up biopsy in adults with a severe initial presentation, especially those older than 40 years, after 1–2 years of starting a GFD to assess for mucosal healing. Furthermore, a follow-up biopsy is the only way possible to confirm a response to GFD in patients with seronegative celiac disease.
- Bone densitometry should be offered to patients with a high risk of osteoporosis (female) or those older than 55 years.
For close relatives of people with coeliac disease (children, brothers/sisters, parents) a predisposition towards coeliac disease is higher (about 10 %) than for the general population. It is recommended therefore that immediate relatives do a serological analysis or submit to a HLA-DQ2 and HLA-DQ8 genotyping. The genotype tells whether the examined person possesses a genetic predisposition towards coeliac disease or not.
