Celiac disease vs. Non-celiac gluten-sensitivity (NCGS)

Gluten intolerance Permanent Possible transient
Symptoms Gluten-dependent Gluten-dependent
Treatment GFD GFD
Anti-transglutaminase antibodies +
Anti-endomysial antibodies +
IgG-anti-gliadin antibodies +/– +
Histology Villous atrophy, crypt hyperplasia, intraepithelial lymphocytosis Normal, at most intraepithelial lymphocytosis (Marsh 1)
Genetic predisposition HLA DQ2/DQ8 No
Diagnosis Positive serology and histology Step 1 = response to GFD + Step 2 = Gluten-challenge with crossover (Salerno criteria, 2015)

CD – celiac disease, NCGS – non-celiac gluten sensitivity, GFD – Gluten-free diet

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