[Adult celiac disease]

Celiac disease is a chronic enteropathy caused by intolerance to gluten. The true prevalence of this condition is much greater than previously recognized, with more silent cases being diagnosed and a greater proportion of cases diagnosed later in adulthood. It presents with a spectrum of clinical manifestations and histological abnormalities. Duodenal biopsy remains the gold standard for diagnosis of celiac disease, even though there are new serologic tests that are very specific. Correlation of clinical, serologic, and histological features are essential for a definitive diagnosis of celiac disease. The pathogenesis consists in an interaction between genetic, immunologic and environmental factors, which interact with HLA molecules to activate an immunologic response in the small bowel mucosa causing tissue damage. The main treatment is a free gluten diet. Health risks for untreated celiac disease appear to be greater compared with those patients who adhere to this treatment.