1. Introduction

Celiac disease (CD) is an immune – mediated systemic disorder elicited by gluten related prolamines in genetically susceptible individuals and characterised by the presence of variable combination of gluten- dependent clinical manifestations, CD- specific antibodies, HLA –DQ2 or HLA – DQ8 haplotyps, and enteropathy.

Diagnostic criterias for CD in Slovakia are from the ESPGHAN 1990 guidelines and were published in 2009 ^[1]. Revised criterias for diagnosing celiakia ESPGHAN 2011 were not integrated into expert recommendations in Slovakia, but they have been used in indicated cases. A work group for CD by Slovak gastroenterology society /SGS/ was established in 2011, there are pediatric gastroenterologies and gastroenterologies for adults from privat and civil facilities.

2. Diagnostic of CD / Diagnostic Tools

- clinic: patient with gastrointestinal symptoms, but also non-specific symptoms;

- laboratory tests: CD – specific antibodies including endomysial antibodies (EMA), autoantibodies against tissue transglutaminase (TG2), and antibodies against deamidated forms of gliadin peptides (DGP);

- enterobiopsy examination, evaluation by Marsh;

- in the case of equivocal results- examination of HLA DQ2, DQ8;

Dated to end of December 2013, there were 5 412 000 people living in Slovakia. Estimated incidence of CD in Slovakia is – 0.5 to 1 % of the population what makes 50 000 celiacs in Slovakia.

In the years 2003, 2007, 2011 were contacted all gastroenterologists of Slovakia to report the number of their patients with diagnosed CD.

3. Results and Discussion

The number of patienst with CD

- in 2004 : 2 986, prevalence 1: 1 792

- in 2008 : 7 930, prevalence 1: 677

- in 2012 : 14 500, prevalence 1: 404

This number is much higher today. These results were published in major professional forums of Slovak gastroenterology society. Each patient with diagnosed CD, who is cured in a gastroenterology clinic, has since 2006 the possibility for prescriptions up to 50 specific gluten free products, partially covered by health insurance. 70 % of the costs are burned by the state. All of these products (wheat, readymade products) are strictly controlled. The prescriptions are limited by the age of the patient and by the monthly quantity prescribed by the doctor according to the diagnosed criterias. It is a big help for patients. Families with CD patient need to beaware of their increase risk of CD, thus first- degree relative should consider being tested, especially if anyone has signs or symptoms of the condition /testing is typically done with a blood antibody test.

Slovak republic has few qualified dietitians who can educate patients about lifestyle under gluten free diet. That's one of the main reasons why they form citizen communities. There are 11 of these communities in Slovakia and each of it has its medical expert. These communities together hand in their demands to the Ministry of Health or Ministry of Labour, Social affairs and Family.

4. Conclusion

Estimated incidence of CD in Slovakia is 0.5 - 1 %. This result clearly indicates an increase of incidence of CD in Slovakia. This means that we must improve the detection of the disease in the context of better diagnostic methods that are currently available.

References

[1]	Pekarova, B., Pekarek, B., Kabatova, J.: Racionálna diagnostika a liečba celiakie. Herba publisher, Bratislava, 2009, 1-8.
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