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Celiac sprue.

Andrés Cárdenas¹, Ciarán P Kelly

¹Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.

Seminars in Gastrointestinal Disease

|December 5, 2002

Summary

This summary is machine-generated.

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Celiac disease is an autoimmune disorder triggered by gluten in genetically susceptible individuals, causing intestinal damage. Lifelong gluten avoidance is crucial for managing symptoms and preventing complications.

Area of Science:

Gastroenterology
Immunology
Genetics

Background:

Celiac disease (or gluten-sensitive enteropathy) is a significant small intestine malabsorption disorder.
It affects genetically predisposed individuals upon wheat gluten ingestion.

Observation:

Characterized by intestinal malabsorption and villous atrophy.
Clinical and histological improvements occur with a strict gluten-free diet, with relapse upon gluten reintroduction.
Prevalence is high in Western Europe and North America, affecting 1:120 to 1:300 individuals.

Findings:

Pathogenesis involves T-cell activation in HLA-DQ2 positive individuals by gluten peptides.
Diagnosis is increasingly recognized in adults, with varied presentations from asymptomatic to severe.

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Extraintestinal manifestations like anemia, osteopenia, and associated conditions (diabetes, hypothyroidism) are common.

Implications:

Highly sensitive serologic markers aid diagnosis, but small intestine biopsy remains definitive.
Lifelong gluten avoidance is the established treatment to control symptoms and prevent complications.