Table 3. Comparison between celiac disease and non-celiac gluten sensitivity features.
| Celiac disease | Non-celiac gluten sensitivity | |
|---|---|---|
| Epidemiology | 1% | To be defined (range 0.63%–6%) |
| Duration | Permanent | Unknown |
| Prevalent immune pathogenic mechanism | Adaptive immunity | Innate immunity |
| Onset | At any age | Adults (rare in pediatric age) |
| Sex | Female/male ratio 2∶1 | Female/male ratio >3∶1 |
| Time interval between gluten ingestion and symptoms | Weeks to years | Hours or a few days |
| Clinical picture | Intestinal and extraintestinal (systemic) | Intestinal and extra-intestinal (mainly neurological) |
| Biomarkers | tTGA, EmA, DGP | None (positivity for AGA in approximately 50% of cases but low specificity) |
| Genetics | HLA-DQ2 and -DQ8 linked | No known genetic link |
| Duodenal histology | From mild lesions to villous atrophy | Normal or less frequently mild lesions |
| Familiarity | 3%–17% of first degree relatives are celiacs | Unknown, but more than 10% of NCGS pts have a relative with celiac disease |
| Autoimmune disorders | Frequent association (present in 10%–25% of celiac patients) | Unknown (a longer follow-up is needed) |
| Outcome (complications) | Refractory celiac disease, lymphoma, small-bowel carcinoma (rare (<1%) but with a poor prognosis) | Unknown (a longer follow-up is needed) |
AGA, anti-gliadin antibodies; DGP, deamidated gliadin peptide antibodies; HLA, histocompatibility leukocyte antigen; NCGS, non-celiac gluten sensitivity; tTGA, tissue transglutaminase.