The Oslo definitions for coeliac disease and related terms
- Jonas F Ludvigsson1,2,
- Daniel A Leffler3,
- Julio C Bai4,
- Federico Biagi5,
- Alessio Fasano6,
- Peter H R Green7,
- Marios Hadjivassiliou8,
- Katri Kaukinen9,
- Ciaran P Kelly3,
- Jonathan N Leonard10,
- Knut Erik Aslaksen Lundin11,
- Joseph A Murray12,
- David S Sanders13,14,
- Marjorie M Walker14,
- Fabiana Zingone15,
- Carolina Ciacci16
- 1Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
- 2Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- 3Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- 4Department of Medicine, Dr C. Bonorino Udaondo Gastroenterology Hospital, Del Salvador University, Buenos Aires, Argentina
- 5Coeliac Centre/First Department of Internal Medicine, University of Pavia, Pavia, Italy
- 6Center for Coeliac Research, University of Maryland School of Medicine, Baltimore, Maryland, USA
- 7Coeliac Disease Center, Columbia University, New York, New York, USA
- 8Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK
- 9School of Medicine, FIN-33014 University of Tampere, Tampere, Finland
- 10Department of Dermatology, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
- 11Department of Gastroenterology and Centre for Immune Regulation, Oslo University Hospital, Oslo, Norway
- 12Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
- 13Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Unversity of Sheffield, Sheffield, UK
- 14Centre for Pathology, Faculty of Medicine, Imperial College, St Mary's Hospital, London, UK
- 15Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy
- 16Department of Gastroenterology, University of Salerno, Salerno, Italy
- Correspondence to Dr Daniel Leffler, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA;
Contributors CC and DAL initiated the study. JFL coordinated the project, conducted the web survey on coeliac disease definitions, and wrote the first draft of the paper. All authors contributed to the literature searches, contributed to the writing of the article, and approved the final version of the article.
- Revised 17 January 2012
- Accepted 20 January 2012
- Published Online First 16 February 2012
Objective The literature suggests a lack of consensus on the use of terms related to coeliac disease (CD) and gluten.
Design A multidisciplinary task force of 16 physicians from seven countries used the electronic database PubMed to review the literature for CD-related terms up to January 2011. Teams of physicians then suggested a definition for each term, followed by feedback of these definitions through a web survey on definitions, discussions during a meeting in Oslo and phone conferences. In addition to ‘CD’, the following descriptors of CD were evaluated (in alphabetical order): asymptomatic, atypical, classical, latent, non-classical, overt, paediatric classical, potential, refractory, silent, subclinical, symptomatic, typical, CD serology, CD autoimmunity, genetically at risk of CD, dermatitis herpetiformis, gluten, gluten ataxia, gluten intolerance, gluten sensitivity and gliadin-specific antibodies.
Results CD was defined as ‘a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals’. Classical CD was defined as ‘CD presenting with signs and symptoms of malabsorption. Diarrhoea, steatorrhoea, weight loss or growth failure is required.’ ‘Gluten-related disorders’ is the suggested umbrella term for all diseases triggered by gluten and the term gluten intolerance should not to be used. Other definitions are presented in the paper.
Conclusion This paper presents the Oslo definitions for CD-related terms.
- coeliac disease
- paediatric gastroenterology
- antiendomysial antibodies
- gliadin immunology
- epithelial permeability
- tight junction
- diarrhoeal disease
- bacterial pathogenesis
- epithelial barrier
- intestinal permeability
- mucosal barrier
- small intestinal biopsy
- mucosal immunity
- bacterial enterotoxins
- bacterial infection
- small intestinal absorption
- gastrointestinal bleeding
- Helicobacter pylori
- HLA class II alleles
- inflammatory diseases
- irritable bowel syndrome
Funding JFL was supported by the Swedish Research Council (522-2A09-195) and the Swedish Society of Medicine while writing the draft of this paper. DAL is supported by the National Institute of Health (NIH DK1042103881). None of the funding organisations had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review, or approval of the article.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data are available on request.