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A case study of a 31-year-old single woman, who was underweight and complained of restrictive eating, nausea, and occasional vomiting after meals, is described. She was diagnosed with celiac disease after an initial diagnosis of atypical eating disorder, thus was suggested the implementation of gluten-free diets for relief.

People who have medical conditions that are possibly related to celiac disease should be tested for celiac disease whether they have symptoms or not. These conditions include diabetes, anemia, chronic fatigue, irritable bowel, gastrointestinal cancer, and autoimmune disorders. Celiac disease is a malabsorption syndrome caused by an autoimmune reaction to gluten, a protein in wheat, rye, barley, and other grains. Some people may have this condition and not know it because they don't have the usual symptoms.

Byline: Vildan. Ertekin, Mahya. Tosun, Teoman. Erdem Sir, Celiac disease (CD) is a life-long gluten sensitive intestinal enteropathy with multifactorial etiology. The disease provides an exciting model where both genetic [...]

Byline: G. Martinez (1), N. R. B. Israel (2), J. J. White (1) Keywords: KeywordsaCeliac disease; Small-bowel intussusception; Failure to thrive Abstract: aCramping abdominal pain with intermittent intestinal obstruction finally prompted investigation in a 4A1/2-year-old boy with severe failure to thrive (FTT). An entero-enteric intussusception was corrected, and celiac disease was identified as the cause of his inanition. Concomitant FTT and cramping abdominal pain should prompt investigation for celiac disease and small-bowel intussusception. Author Affiliation: (1) Division of Pediatric Surgery, The Children's Hospital at the Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA, USA, GE (2) Section of Pediatric Gastroenterology, The Children's Hospital at the Medical Center of Central Georgia and Mercer University School of Medicine, Macon, GA, USA, GE (3) Division of Pediatric Surgery, 840 Pine Street, Suite 700, Macon, GA 31210, USA, US Article note: Accepted: 13 September 1999

* Context.--Celiac disease (CD) is a common immune-mediated disorder that occurs in genetically predisposed individuals (carriers of HLA-DQ2 and DQ8 haplotypes) on consumption of wheat (gluten). It is characterized by inflammation of the small-intestinal mucosa and myriad gastrointestinal and systemic manifestations. Celiac disease is common in the general population (prevalence, 0.5%-1%). Currently, small-bowel biopsy is considered the gold standard for diagnosing CD. However, the role of serologic testing in the diagnosis of CD has evolved, from being a supportive test to supplanting intestinal biopsies in certain patient populations. Objective.--To summarize key aspects of histopathologic assessment, discuss the benefit of standardized pathology reports, impact of the site and number of small-bowel biopsy samples on diagnosis, and recommendations regarding serologic testing. Data Sources.--Literature review of publications on CD and experience with histopathologic review of biopsies at the Department of Pathology and Cell Biology, Columbia University Medical Center, New York-Presbyterian Hospital, New York. Conclusions.--Intraepithelial lymphocytosis in the context of villous atrophy is considered a characteristic histologic finding of CD; however, it is a rather nonspecific finding. A growing list of publications has also indicated that the detection of intraepithelial lymphocytosis in the absence of villous atrophy has rather low specificity for CD. Therefore, communication between pathologists and gastroenterologists is paramount, as is knowledge regarding the pertinent clinical and laboratory data, in distinguishing between CD and other disorders with similar histopathologic and clinical manifestations. (Arch Pathol Lab Med. 2012; 136:735-745; doi: 10.5858/arpa.2011-0572-RA), Celiac disease, also known as gluten-sensitive enteropathy, celiac sprue, or nontropical sprue (see reference for terminology) is a common immune-mediated disorder characterized by chronic inflammation of the small intestine, and [...]

Celiac disease is an intestinal malabsorption syndrome characterized by intestinal bleeding, diarrhea, malnutrition, and disordered calcium metabolism. This condition is caused, at least in part, by a hypersensitivity to dietary gluten (a protein found in wheat). Celiac disease has been reported to have a higher prevalence and to occur in a latent form in patients with herpetiform dermatitis (an inflammatory disease of the skin); both of these conditions have been linked to disorders of the immune system. It has been reported that increased levels of a particular subclass of immune cell (T lymphocytes which express the gamma/delta receptor molecule) may be a diagnostic marker for the presence of both latent and overt celiac disease. A case (the first such documented case) is described of a 35-year-old man who was studied because of an abnormality in blood chemistry (low serum titer of reticulin antibody) and because of the presence of overt celiac disease in his son. (The patient had been diagnosed with epilepsy, and suffered infrequent seizures; this was not thought to be related to the variables assessed in this case.) Intestinal biopsy revealed completely normal anatomy of the small intestine, and celiac disease would have been ruled out on this basis alone. Total lymphocyte level was normal in the biopsy specimen, but the number of cells expressing the gamma/delta T cell receptor was 10 times that found in normal subjects. Two years later, a subsequent intestinal biopsy specimen was taken because of celiac disease symptom onset; microscopic anatomy was consistent with a diagnosis of celiac disease. A biopsy taken during a period in which the patient was on a gluten-free diet showed normal intestinal anatomy, but continued elevation of gamma/delta T cell receptor-positive lymphocytes. (Consumer Summary produced by Reliance Medical Information, Inc.)

* Context.--Celiac sprue affects genetically susceptible individuals, who develop small intestinal injury and malabsorption following dietary exposure to gluten. The histologic features are nonspecific but characteristic. Objectives.--To outline the histologic features of celiac sprue and the necessary clinical context to permit a diagnosis of celiac sprue, to assist the pathologist to identify artifactual biopsy changes that may mimic sprue, to define the differential diagnosis for conditions with a similar histology, and to review historic investigations of this disease. Data Sources.--Sources include the historic experiments and clinical work of members of the Gastroenterology Division of the Department of Medicine and experiences with gastrointestinal pathology consultation material at the University of Washington, Seattle, with reference to selected peer-reviewed articles. Conclusions.--Confirmation of a diagnosis of celiac sprue is 2-fold: first, biopsy evidence of a characteristic, but nonspecific, pattern of injury including villous blunting or flattening, surface enterocyte damage, and increased intraepithelial lymphocytes; and second, dramatic clinical response to a gluten-free diet. Complete gluten removal from the diet is effective treatment for patients with symptoms of malabsorption; however, lifelong adherence to the diet is expensive, socially limiting, and nearly impossible on a contemporary diet with manufactured foodstuffs. Therefore, pathologists should avoid overdiagnosis of celiac disease based on minimal, nonspecific histologic changes. (Arch Pathol Lab Med. 2008;132:1594-1599), Celiac sprue (CS) is a complex multigenic disease. Genetically susceptible individuals may develop small intestinal injury and malabsorption from dietary exposure to "gluten" proteins in wheat, barley, and rye. Confirmation [...]