<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7531</journal-id>
<journal-title><![CDATA[Revista Cubana de Pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Pediatr]]></abbrev-journal-title>
<issn>0034-7531</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75312019000400007</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Insuficiencias metodológicas lastran el diagnóstico de la enfermedad celiaca]]></article-title>
<article-title xml:lang="en"><![CDATA[Methodological shortage hampers the diagnostic of celiac disease]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Menéndez]]></surname>
<given-names><![CDATA[Gissel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Andrade Ruiseco]]></surname>
<given-names><![CDATA[Mabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valbuena Rodríguez]]></surname>
<given-names><![CDATA[Mayerly]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alfonso Gonzalez]]></surname>
<given-names><![CDATA[Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Acea]]></surname>
<given-names><![CDATA[Bisleydis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kokuina]]></surname>
<given-names><![CDATA[Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonte Galindo]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Clinicoquirúrgico &#8220;Hermanos Ameijeiras&#8221; Departamento Genética Molecular ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Pediátrico Universitario &#8220;William Soler&#8221; Departamento Medios Diagnósticos ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Medicina Tropical ¨Pedro Kourí¨ Departamento de Parasitología ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>91</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312019000400007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312019000400007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312019000400007&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La enfermedad celiaca es el resultado de una sensibilidad permanente al gluten. Puede conducir principalmente a trastornos intestinales. Cuatro criterios son utilizados para el diagnóstico de esta enfermedad: clínicos, histológicos, serológicos y moleculares. La insuficiente utilización de estos criterios conduce a falsos diagnósticos de dicha enfermedad.  Objetivo: Demostrar la existencia de falsos diagnósticos de enfermedad celiaca cuando no se utilizan las herramientas necesarias para ello.  Métodos: Se estudiaron 46 niños que fueron remitidos al Servicio de Genética Molecular del Hospital &#8220;Hermanos Ameijeiras&#8221; con diagnóstico de enfermedad celiaca basado en criterios clínicos e histopatológicos. Para completar los procederes diagnósticos, a cada paciente se le determinó anticuerpos antitransglutaminasa previa ingesta de gluten, y los alelos HLA DQ2 y HLA DQ8. Se consideraron pacientes con enfermedad celiaca aquellos casos que cumplieron los cuatro criterios.  Resultados: De los 46 pacientes, trece (28,3 %) fueron negativos a los alelos HLA DQ2/HLA DQ8, lo que niega estén padeciendo de enfermedad celiaca; ocho (17,39 %) fueron positivos a los alelos HLA y negativos a la presencia de anticuerpos, lo que también niega la enfermedad. Es decir, 21 (45,7 %) eran falsos diagnósticos de enfermedad celiaca. Los 25 (54,3 %) restantes, además de los criterios con que fueron remitidos, cumplieron los serológicos (positividad a anticuerpos antitransglutaminasa) y moleculares (positividad para moléculas HLA DQ2/HLADQ8).  Conclusiones: Para un diagnóstico de certeza de enfermedad celiaca es necesario, además de las herramientas clínicas e histopatológicas utilizadas en la red de hospitales pediátricos del país, el uso de procederes serológicos y moleculares.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Celiac disease is a caused by a permanent sensitivity to gluten, which results mainly in functional disorders of the small intestine. To successfully diagnose of celiac disease, it is necessary to properly convey four criteria: clinic, histological, serological and molecular. The insufficient utilization of them in the medical practice could conduce to false diagnosis of celiac disease.  Objective: To demonstrate the occurrence of mistaken diagnoses of celiac disease when the four criteria are not properly addressed.  Methods:  Forty-six children were diagnosed with celiac disease based on clinical and histopathological criteria and remitted to the &#8220;Hermanos Ameijeiras&#8221; Hospital´s Molecular Genetics service. In order to complete the serological and molecular diagnosis procedure, there were detected antitransglutaminase antibodies after gluten ingestion, and HLA DQ2/HLA DQ8 alleles in every child. Individuals who met the four criteria were considered celiac disease patients.  Results: The analysis of 46 patients showed that 13 (28.3%) where negative to the presence of both allele HLA DQ2/HLA DQ8, and hence negative for celiac disease diagnosis. Eight patients (17.39%) where HLA DQ2/HLA DQ8 positive and antitransglutaminase antibodies negative, so they were considered as negative for diagnosis of celiac disease. According to our results, 21 patients (45.7%) were mistakenly diagnosed. The remaining 25 patients (54.3%) where positive for all diagnosis criteria.  Conclusions: In order to successfully diagnose of celiac disease, in addition to clinical and histopathological tools used in the network of pediatrics hospitals in the country, it is necessary to include the serological and molecular method.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[enfermedad celíaca]]></kwd>
<kwd lng="es"><![CDATA[anticuerpos antitransglutaminasa tisular]]></kwd>
<kwd lng="es"><![CDATA[HLA-DQ]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico]]></kwd>
<kwd lng="en"><![CDATA[celiac disease]]></kwd>
<kwd lng="en"><![CDATA[antitransglutaminasa antibodies]]></kwd>
<kwd lng="en"><![CDATA[HLA DQ]]></kwd>
<kwd lng="en"><![CDATA[diagnosis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guandalini]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Assiri]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Celiac Disease: A Review]]></article-title>
<source><![CDATA[Clin Rev Educat]]></source>
<year>2014</year>
<volume>168</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lindfors]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ciacci]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kurppa]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Lundin]]></surname>
<given-names><![CDATA[KEA]]></given-names>
</name>
<name>
<surname><![CDATA[Makharia]]></surname>
<given-names><![CDATA[GK]]></given-names>
</name>
<name>
<surname><![CDATA[Mearin]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coeliac disease]]></article-title>
<source><![CDATA[Nat Rev Dis Primers]]></source>
<year>2019</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tovoli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Masi]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Guidetti]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Negrini]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Paterini]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Bolondi]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical and diagnostic aspects of gluten related disorders]]></article-title>
<source><![CDATA[World J ClinCases]]></source>
<year>2015</year>
<volume>3</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>275-84</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Catassi]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El mapa mundial de la enfermedad celíaca]]></article-title>
<source><![CDATA[Acta Gastroenterol Latinoam]]></source>
<year>2005</year>
<volume>35</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>46-55</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rubio-Tapia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hill]]></surname>
<given-names><![CDATA[ID]]></given-names>
</name>
<name>
<surname><![CDATA[Kelly]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Calderwood]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ACG clinical guidelines diagnosis and management of celiac disease]]></article-title>
<collab>American College of G</collab>
<source><![CDATA[Am Gastroenterol]]></source>
<year>2013</year>
<volume>108</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>656-77</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lau]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Sanders]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Optimizing the diagnosis of celiac disease Curr Opin]]></article-title>
<source><![CDATA[Gastroenterol]]></source>
<year>2017</year>
<volume>33</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>173-80</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Méndez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Carrasco]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mora]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Caracterización de la enfermedad celiaca en niños atendidos en hospitales públicos chilenos]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[M]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev chilena Pediatr]]></source>
<year>2018</year>
<volume>89</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>709-17</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dhroove]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Saps]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Garcia-Bueno]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Leyva Jiménez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rodriguez-Reynosa]]></surname>
<given-names><![CDATA[LL]]></given-names>
</name>
<name>
<surname><![CDATA[Velasco-Benítez]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de trastornos gastrointestinales funcionales en escolares mexicanos]]></article-title>
<source><![CDATA[Rev Gastroenterol México]]></source>
<year>2017</year>
<volume>82</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>13-8</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Polanco]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Montoro]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Arranz]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Protocolo para el diagnóstico precoz de la enfermedad celiaca]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Gobierno de Canaria, España ]]></publisher-loc>
<publisher-name><![CDATA[Ministerio de Sanidad, Servicios Sociales e Igualdad, Servicio de Evaluación del Servicio Canario de la Salud (SESCS)]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Screening of coeliac disease]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2002</year>
<volume>359</volume>
<numero>9310</numero>
<issue>9310</issue>
<page-range>945-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Selleski]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Gandolfi]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Pratesi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Nóbrega]]></surname>
<given-names><![CDATA[YK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simplifying Celiac Disease Predisposing HLA-DQ Alleles Determination by the Real Time PCR Method]]></article-title>
<source><![CDATA[Arq Gastroenterol]]></source>
<year>2015</year>
<volume>52</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>143-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hill]]></surname>
<given-names><![CDATA[ID]]></given-names>
</name>
<name>
<surname><![CDATA[Fasano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Guandalini]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hoffenberg]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Levy]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Reilly]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[NASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related Disorders]]></article-title>
<source><![CDATA[J Pediatric Gastroenterol Nutrit]]></source>
<year>2016</year>
<volume>63</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>156-65</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Galván]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Acevedo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Novoa]]></surname>
<given-names><![CDATA[LI]]></given-names>
</name>
<name>
<surname><![CDATA[Palenzuela]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Rubí]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Desarrollo, validación y registro del sistema Hebreas Line(r) antitransglutaminasa Contribución al diagnóstico de la enfermedad celiaca en Cuba]]></article-title>
<source><![CDATA[Biotecnol Aplicada]]></source>
<year>2008</year>
<volume>25</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>62-5</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<collab>Asociación Médica Mundial</collab>
<source><![CDATA[Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Washington ]]></publisher-loc>
<publisher-name><![CDATA[AMA]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Husby]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Katzka]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[AGA Clinical Practice Update on Diagnosis and Monitoring of Celiac Disease 2014; Changing Utility of Serology and Histologic Measures Expert Review]]></article-title>
<source><![CDATA[Gastroenterol]]></source>
<year>2019</year>
<volume>156</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>885-9</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mubarak]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Nikkels]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Houwen]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ten Kate]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reproducibility of the histological diagnosis of celiac disease]]></article-title>
<source><![CDATA[Scandinav J Gastroenterol]]></source>
<year>2011</year>
<volume>46</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1065-73</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lebwohl]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Rubio-Tapia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Assiri]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Newland]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Guandalini]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnosis of celiac disease]]></article-title>
<source><![CDATA[Gastrointestinal endoscopy clinics of North America]]></source>
<year>2012</year>
<volume>22</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>661-77</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mulder]]></surname>
<given-names><![CDATA[CJJ]]></given-names>
</name>
<name>
<surname><![CDATA[Dieleman]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Celiac Disease Against the Grain in Gastroenterology]]></article-title>
<source><![CDATA[Journal of the Canadian Association of Gastroenterology]]></source>
<year>2018</year>
<volume>20</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>243-50</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castillo]]></surname>
<given-names><![CDATA[NE]]></given-names>
</name>
<name>
<surname><![CDATA[Theethira]]></surname>
<given-names><![CDATA[TG]]></given-names>
</name>
<name>
<surname><![CDATA[Leffler]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The present and the future in the diagnosis and management of celiac disease]]></article-title>
<source><![CDATA[Gastroenterol Report]]></source>
<year>2015</year>
<volume>3</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3-11</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moscoso]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Quera]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad Celiaca Revision]]></article-title>
<source><![CDATA[Rev Med Clin Condes]]></source>
<year>2015</year>
<volume>26</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>612-27</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
