Celiac disease in adult patients

Celiac disease (CD) may affect individuals of any age and sex and may present with various clinical presentations. Specifically, CD has proteiform manifestations, spacing from a totally asymptomatic presentation (silent CD) to few or mild signs or symptoms, such as isolated anemia, osteoporosis, vague or unspecific gastrointestinal symptoms (subclinical CD), and to a frank malabsorption syndrome, including steatorrhea, weight loss, electrolyte imbalance, hypoalbuminemia. Additionally, different extraintestinal manifestations may accompany CD, such as dermatitis herpetiformis, other skin/oral diseases, neuropsychiatric alterations, and liver function test abnormalities. In this Chapter, we will discuss the possible clinical manifestations of CD in adults, also including specific populations (e.g., the elderly, patients with other autoimmunity), how to follow-up CD patients, the mortality related to CD, and the impact of the recent Covid-19 pandemic on CD patients.