Coeliac disease with mild mucosal abnormalities: a report of four patients

In a routine adult gastroenterological practice, seventeen (15%) of 123 patients had small-intestinal biopsies which were neither normal nor were completely flat as found in classical coeliac disease. Some of these had a possible cause for the mild mucosal abnormality, but in six there was no other apparent cause and all four of these who were treated with a gluten-free diet responded morphologically and symptomatically. It is concluded that at least these four patients have coeliac disease in a mild form and that the classical flat biopsy is not a prerequisite for the diagnosis of coeliac disease.