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Diagnosis and treatment of gluten-sensitive enteropathy.
Adv Intern Med 1990; 35:341-63AI

Abstract

Celiac disease is defined as a GSE. The small intestinal histological appearance of villous atrophy with crypt hyperplasia, inflammatory cell infiltrate of the lamina propria, and epithelial cell abnormalities is characteristic but not pathognomonic of the disorder. Confirmation of the diagnosis depends on histological improvement when gluten is removed from the diet and deterioration following gluten reintroduction. The pathogenesis of celiac disease appears to require interaction between a number of factors both intrinsic (genetic susceptibility, activation of the immune system) and extrinsic (gluten susceptibility, activation of the immune system) and extrinsic (gluten and possibly other environmental factors). The diagnosis of GSE may be delayed or missed unless the clinician is aware of the broad clinical spectrum of disease presentation. Although celiac disease is widely perceived as a malabsorption syndrome of childhood, the diagnosis is increasingly being made for the first time in adult life. A significant number of patients have no GI symptoms whatsoever. Small intestinal biopsy through the endoscope is the initial and definitive investigation. Most patients show excellent clinical and histological response to a gluten-free diet. The commonest reason for poor response is continuing intentional or inadvertent gluten intake. A minority of patients develop complications, in particular intestinal malignancy, including enteropathy-associated T-cell lymphoma.

Authors+Show Affiliations

Dublin University, Trinity College, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

2405597

Citation

Kelly, C P., et al. "Diagnosis and Treatment of Gluten-sensitive Enteropathy." Advances in Internal Medicine, vol. 35, 1990, pp. 341-63.
Kelly CP, Feighery CF, Gallagher RB, et al. Diagnosis and treatment of gluten-sensitive enteropathy. Adv Intern Med. 1990;35:341-63.
Kelly, C. P., Feighery, C. F., Gallagher, R. B., & Weir, D. G. (1990). Diagnosis and treatment of gluten-sensitive enteropathy. Advances in Internal Medicine, 35, pp. 341-63.
Kelly CP, et al. Diagnosis and Treatment of Gluten-sensitive Enteropathy. Adv Intern Med. 1990;35:341-63. PubMed PMID: 2405597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis and treatment of gluten-sensitive enteropathy. AU - Kelly,C P, AU - Feighery,C F, AU - Gallagher,R B, AU - Weir,D G, PY - 1990/1/1/pubmed PY - 1990/1/1/medline PY - 1990/1/1/entrez SP - 341 EP - 63 JF - Advances in internal medicine JO - Adv Intern Med VL - 35 N2 - Celiac disease is defined as a GSE. The small intestinal histological appearance of villous atrophy with crypt hyperplasia, inflammatory cell infiltrate of the lamina propria, and epithelial cell abnormalities is characteristic but not pathognomonic of the disorder. Confirmation of the diagnosis depends on histological improvement when gluten is removed from the diet and deterioration following gluten reintroduction. The pathogenesis of celiac disease appears to require interaction between a number of factors both intrinsic (genetic susceptibility, activation of the immune system) and extrinsic (gluten susceptibility, activation of the immune system) and extrinsic (gluten and possibly other environmental factors). The diagnosis of GSE may be delayed or missed unless the clinician is aware of the broad clinical spectrum of disease presentation. Although celiac disease is widely perceived as a malabsorption syndrome of childhood, the diagnosis is increasingly being made for the first time in adult life. A significant number of patients have no GI symptoms whatsoever. Small intestinal biopsy through the endoscope is the initial and definitive investigation. Most patients show excellent clinical and histological response to a gluten-free diet. The commonest reason for poor response is continuing intentional or inadvertent gluten intake. A minority of patients develop complications, in particular intestinal malignancy, including enteropathy-associated T-cell lymphoma. SN - 0065-2822 UR - https://www.unboundmedicine.com/medline/citation/2405597/Diagnosis_and_treatment_of_gluten_sensitive_enteropathy_ L2 - https://medlineplus.gov/celiacdisease.html DB - PRIME DP - Unbound Medicine ER -