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Coeliac disease: an update for pathologists

¹ Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
² Division of Pathology, St Michael’s Hospital, Toronto

Correspondence to:
R Chetty
Department of Pathology, University Health Network, Princess Margaret Hospital, 610 University Avenue, 4th Floor, Suite 302, Toronto, Ontario, Canada M5G 2M9;Runjan.Chetty{at}uhn.on.ca
ABSTRACT
Coeliac disease is the manifestation of an immune hypersensitivity reaction towards gluten and related proteins, in genetically predisposed people. Although the precise pathogenesis of this condition remains to be fully elucidated, it is probably multifactorial in origin. The diagnosis of coeliac disease has traditionally depended on intestinal biopsies alone; nowadays, the diagnosis has been expanded to include an array of serological markers. This review is intended to offer pathologists an update of the relevant history and immunopathology pertaining to coeliac disease and also to offer recommendations on the ongoing responsibilities of the pathologist in the diagnosis and reporting of coeliac disease.

Abbreviations: HLA, human leucocyte antigen; IELs, intraepithelial lymphocytes; NK, natural killer; Th, T helper