Celiac Disease aka Celia Sprue or Gluten-Sensitive Enteropathy

Celiac disease is defined as a chronic disease characterized by malabsorption & diarrhea precipitated by ingestion of food products containing gluten.

 

It affects 1% in the general population and 5% in high risk groups (eg. first degree relatives of people with the disease), and it is slightly more common in women.  Its highest incidence occur during:

  1. infancy and the initial 36 months of age − secondary to the introduction of food containing gluten;
  2. between the ages of 20-29 years of age − frequently associated with pregnancy and severe anemia during pregnancy;
  3. between 50-59 years of age

 

The most common causes are:

  • Autoimmune
  • Sensitivity to gliadin − a protein fraction of gluten found in barley, rye and wheat 

 

The most commonly experienced signs and symptoms of celiac disease are:

  • Fatigue, weight loss
  • Dermatitis (atopical and herpetiformis)
  • Canker sores (aphthous ulcers), angular chelitis
  • Diarrhea
  • Sometimes nausea, vomiting and abdominal pain
  • In infants and children: weight loss, short stature, failure to thrive and dyspepsia

 

The following diagnostic tools or results are often used or found to diagnose celiac disease:

  • Vitamin B12 deficiency, folic acid deficiency and iron deficiency anemia
  • Low calcium, low magnesium
  • IgA endomysial antibodies, HLA (human leukocyte antigen) DQ2DQ8 testing
  • Endoscopy with small bowel biopsy 

 

References

  • Beers MH & Berkow R (Editors).  1999.  The Merck Manual of Diagnosis and Therapy (17th Ed.).  Merck Research Laboratories: Whitehouse Station, NJ. 
  • Ferri FF.  2007.  Ferri’s Clinical Advisor: Instant Diagnosis and Treatment.  Mosby Elsevier: Philadelphia, PA.
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