Abstract
Celiac disease is a frequent autoimmune disorder of children and adults with world-wide distribution. The prevalence in Czech Republic amounts to 1:200-1:250.
In Czech population celiac disease remains underdiagnosed and frequently diagnosed at a late stage. The reasons include an altered phenotype of the disease with frequent extraintestinal symptoms in adults.
The manifestation of celiac disease depends on the genetic disposition as well as on the permeability of the intestinal mucosal barrier modulated by the intestinal microbiome and the mucosal immune system. Undiagnosed celiac disease may be a serious condition due to malnutrition, associated autoimmune conditions and life-threatening complications.
The only causal therapy is the life-long gluten-free diet with complete exclusion of all cereals. This regimen is very expensive.
Breast-feeding decreases the prevalence of celiac disease. Viral enteritis in the first year of life may damage the mucosal barrier and facilitate the manifestation of celiac disease.
The Program of "Targeted Celiac Disease Screening" published by Czech Ministry of Health may enable to reveal the extensive population of undiagnosed celiac subjects and start their therapy with gluten-free diet.