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Review article: spectrum of gluten-related disorders: Consensus on new nomenclature and classification

February 2012 | 5 min read


This review article provides an overview of the recognized gluten-related disorders and proposes nomenclature and classification processes and diagnostic algorithms for them. Indeed, in the last 10 years, the awareness of these disorders, spawned by the dramatic increase in celiac disease, has markedly increased. Additionally, the number of people using gluten-free diets is exceeding the estimated number of people with celiac disease, apparently the result of other conditions resulting from wheat or gluten sensitivities. 

Key Points

The review organized a panel of 15 industry experts who proposed new nomenclature and classifications for three categories representing the collective spectrum of gluten-related disorders.

The categories are:

  • Allergic reactions (with onset of symptoms within minutes to hours after gluten exposure), such as wheat allergy
  • Autoimmune reactions (with onset of symptoms from weeks to years after gluten exposure), including celiac disease, dermatitis herpetiformis and gluten ataxia
  • Immune-mediated reactions (with onset of symptoms from hours to day after gluten exposure), such as distressful symptoms often similar to celiac disease, but not accompanied by the distinctive autoimmune markers of celiac disease

Key Takeaways

A broader spectrum of gluten-related disorders is now recognized, including a category characterized by not being consistent with the well-documented autoimmune or allergic markers associated with celiac disease or wheat allergy. Improved diagnosis and intervention based on these categories and their nuances may improve diagnosis and intervention.


Sapone A, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine, 2012; 10:13