Pneumococcal vaccination in celiac disease

Introduction: Celiac disease (CD) is an immune-mediated disorder associated with gluten exposure ingenetically predisposed subjects.Areas covered: Infectious disease is one of the causes of morbidity and mortality in CD patients.Invasive streptococcus pneumoniae (pneumococcus) is a particularly dangerous morbid condition inboth the general population and celiac patients. Pneumococcal vaccination is the most effective meansfor its prevention.Expert opinion: In CD, evaluation of spleen function should be useful to select patients who maybenefit from vaccination to reduce the risk of pneumococcal disease. Different strategies could beemployed: physicians could search for signs of hyposplenism on peripheral blood smear or abdominalultrasound. However, the best strategy to identify which patients will benefit from pneumococcalvaccination has not yet been defined.