Diagnosis of Celiac Sprue

Farrell, Richard J.; Kelly, CiarĂ¡n P.
December 2001
American Journal of Gastroenterology;Dec2001, Vol. 96 Issue 12, p3237
Academic Journal
Celiac sprue is a common lifelong disorder affecting 0.3-1% of the Western world and causing considerable ill health and increased mortality, particularly from lymphoma and other malignancies. Although high prevalence rates have been reported in Western Europe, celiac sprue remains a rare diagnosis in North America. Whether celiac sprue is truly rare among North Americans or is simply underdiagnosed is unclear, although serological screening of healthy American blood donors suggests that a large number of American celiacs go undiagnosed. Celiac sprue is an elusive diagnosis, and often its only clue is the presence of iron or folate deficiency anemia or extraintestinal manifestations, such as osteoporosis, infertility, and neurological disturbances. The challenge for gastroenterologists and other physicians is to identify the large population of undiagnosed patients that probably exists in the community and offer them treatment with a gluten-free diet that will restore the great majority to full health and prevent the development of complications. The advent of highly sensitive and specific antiendomysium and tissue transglutaminase serotogical tests has modified our current approach to diagnosis and made fecal fat and D-xylose absorption testing obsolete. A single small bowel biopsy that demonstrates histological findings compatible with celiac sprue followed by a favorable clinical and serological response to gluten-free diet is now considered sufficient to definitely confirm the diagnosis. We review the wide spectrum of celiac sprue, its variable clinical manifestations, and the current approach to diagnosis.


Related Articles

  • GLUTEN ANTIBODIES AND TROPICAL SPRUE. Cane, Walter // American Journal of Gastroenterology;Jun1969, Vol. 51 Issue 6, p538 

    Presents an abstract of the study "Gluten Antibodies and Tropical Sprue," by Rodrigo Menendez-Corrada and Maria Esther Belaval, published in November 1968 issue of the "American Journal of Digestion Disorders."

  • A Non-Human Primate Model for Gluten Sensitivity. Bethune, Michael T.; Borda, Juan T.; Ribka, Erin; Liu, Michael-Xun; Phillippi-Falkenstein, Kathrine; Jandacek, Ronald J.; Doxiadis, Gaby G. M.; Gray, Gary M.; Khosla, Chaitan; Sestak, Karol // PLoS ONE;2008, Vol. 3 Issue 2, p1 

    Background and Aims: Gluten sensitivity is widespread among humans. For example, in celiac disease patients, an inflammatory response to dietary gluten leads to enteropathy, malabsorption, circulating antibodies against gluten and transglutaminase 2, and clinical symptoms such as diarrhea. There...

  • Inhibitors for human TGM2 enzyme. Brazil, Melanie // Nature Reviews Drug Discovery;Jun2003, Vol. 2 Issue 6, p420 

    Focuses on proteolytically stable peptide inhibitors of the enzyme, tissue transglutaminase (TGM2) which is involved in the production of autoantigens from gluten. Benefit of selective inhibition of TGM2 ; Effect of ingesting gluten proteins on the physiology of coeliac patients; Impact of...

  • GLUTEN SENSITIVITY. Litwins, Joseph // American Journal of Gastroenterology;Jun1956, Vol. 25 Issue 6, p562 

    Reports on the study conducted on three patients sprue syndrome and regional ileitis to demonstrate their sensitivity to gluten. Medical history of the patients; Orientation on a diet program; Analysis of the study conducted physician Louis Greenwald.

  • Lymphoma Presenting as "Idiopathic" Juvenile Osteoporosis. Child, J.A.; Smith, I.E. // British Medical Journal;3/29/75, Vol. 1 Issue 5960, p720 

    Presents a case on the osteoporosis manifestation of lymphoma. Occurrence of osteolytic lesions in early lymphoma; Description of acute lymphoblastic leukemia; Classification of lymphomas based on morphology.

  • Infant Gluten and Celiac Disease: Too Early, Too Late, Too Much, Too Many Questions. Farrell, Richard J. // JAMA: Journal of the American Medical Association;5/18/2005, Vol. 293 Issue 19, p2410 

    Reports on celiac disease or gluten-sensitive enteropathy which has emerged as a common health problem in North America and Western Europe. How celiac disease is considered to be an autoimmune-type disease with tissue transglutaminase (tTG) suggested as a major autoantigen; How a gene dose...

  • IDIOPATHIC NONTROPICAL SPRUE (MALABSORPTION SYNDROME). Wollaeger, Eric E.; Green, Paul A. // American Journal of Gastroenterology;Jun1961, Vol. 35 Issue 6, p569 

    Nontropical sprue is a chronic remittent disease characterized by impaired absorptive and motor functions of the small intestine resulting in multiple and often serious nutritional deficiencies. The disease lacks gross pathologic changes but does display characteristic abnormalities of the...

  • Nontropical Sprue with Several Major Complications. Caserta, Silvio J. // American Journal of Gastroenterology;Jul1987, Vol. 82 Issue 7, p689 

    A 43-yr-old woman with celiac disease had an excellent response to a gluten-free diet for 20 yr. Subsequently, she developed the complications of chronic nongranulomatous ulcerative jejunitis and malignant histiocytosis associated with some atypical clinical and pathological features. The early...

  • Recent Advances in Collagenous Sprue. Freeman, Hugh James // Current Medical Literature: Gastroenterology;2012, Vol. 31 Issue 2, p33 

    The article discusses collagenous sprue, a unique small bowel mucosal disorder characterized by persistent diarrhea, small intestinal biopsy lesion, mucosal inflammation in the small intestine and lack of gluten-free diet. It also discusses the disorder's distinctive features from the celiac...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics