Background and Aim: Celiac disease (CeD) is increasingly recognized as a global disorder, yet its epidemiology and clinical burden remain poorly defined across much of Southeast Asia. In Vietnam, limited awareness, fragmented diagnostic pathways, and scarce population-based data may contribute to substantial under-recognition. We aimed to synthesize current evidence on CeD in Vietnam and Southeast Asia, identify key diagnostic gaps, and outline practical opportunities for earlier recognition.
Methods: We conducted a narrative synthesis of published literature addressing CeD epidemiology, clinical presentation, serologic testing, endoscopic and histopathologic diagnosis, and healthcare access in Vietnam and Southeast Asia, interpreted in the context of contemporary international diagnostic recommendations.
Results: Available regional data are sparse and heterogeneous, precluding reliable estimates of CeD prevalence in several Southeast Asian countries, including Vietnam. Recurrent diagnostic barriers include low clinical suspicion, particularly in patients with non-classical or extraintestinal manifestations; inconsistent use of tissue transglutaminase IgA with total IgA; variable access to confirmatory testing; non-standardized duodenal biopsy and histopathology practices; and initiation of a gluten-free diet before diagnostic evaluation. These gaps may lead to missed or delayed diagnoses and make low case detection difficult to distinguish from genuinely low disease prevalence. Opportunities include risk-based case finding in high-risk groups, standardized serology while patients remain on a gluten-containing diet, adequate multi-site duodenal biopsy protocols, expert pathology review, selective HLA-DQ2/DQ8 testing in equivocal cases, and development of national referral pathways, registries, and regional collaborative networks.
Conclusions: Celiac disease in Vietnam and Southeast Asia is likely under-recognized rather than adequately characterized. A coordinated strategy combining clinician education, standardized diagnostic pathways, targeted case finding, and regional epidemiologic research is needed to define the true disease burden and enable earlier, more accurate diagnosis.