[Gluten enteropathy--occurrence, diagnosis, therapy]

Gluten enteropathy is a chronic all-life disease, characterized by typical inflammatory changes of the small bowel mucosa. It is the genetically determined autoimmune disease with permanent intolerance to gluten. Its clinical signs are very heterogeneous and also the severity of intestinal changes varies considerably. It frequently presents with atypical symptoms, as many as 80% of adult patients have no gastrointestinal troubles at all. The present estimated prevalence is 1:200 - 1:250. The diagnosis is based on criteria of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition revised in 1990, above all on the detection of serum antibodies to endomysium and tissue transglutaminase. The five forms are distinguished: classic, subclinical, latent, potential and silent. Coeliac disease and dermatitis herpetiformis are considered to be two identical forms of the gluten enteropathy manifestations. Coeliac disease is frequently associated with other autoimmune diseases--diabetes mellitus, autoimmune thyreoiditis, hepatitis, IgA deficiency. Permanent gluten free diet is the cornerstone of the therapy; untreated gluten enteropathy is a serious illness, considered to be a significant precancerosis.