@entity66 is a lifelong intolerance to the gluten found in @entity3505 , @entity2247 and rye, and some @entity1 are also sensitive to oats. The disease is genetically determined, with 10% of the first-degree relatives affected and 75% of monozygotic twins being concordant. Of the @entity1 with @entity66 95% are human leucocyte antigen (HLA)-DQ2 or HLA-DQ8 positive. Characteristically, the jejunal mucosa becomes damaged by a T-cell-mediated autoimmune response that is thought to be initiated by a 33-mer peptide fragment in A2 gliadin, and @entity1 with this disorder have raised levels of anti-endomysium and @entity8265 antibodies in their blood. @entity66 is the major diagnosable food intolerance and, with the advent of a simple blood test for case finding, prevalence rates are thought to be approximately 1:100. Classically, the condition presented with @entity8884 and @entity177 to thrive in infancy, but this picture has now been overtaken by the much more common presentation in adults, usually with non-specific symptoms such as tiredness and @entity417 , disturbance in bowel habit or following @entity174 . Small intestinal biopsy is necessary for diagnosis and shows a characteristically flat appearance with crypt @entity509 and infiltration of the epithelium with lymphocytes. Diet is the key to management and a gluten-free diet effectively cures the condition. However, this commitment is lifelong and many aisles in the supermarket are effectively closed to individuals with @entity66 . Compliance can be monitored by measuring antibodies in blood, which revert to negative after 6-9 months. @entity1 with minor symptoms, who are found incidentally to have @entity66 , often ask whether it is necessary to adhere to the diet. Current advice is that dietary adherence is necessary to avoid the long-term complications, which are, principally, @entity170 and @entity706 . However, risk of these complications diminishes very considerably in @entity1 who are on a gluten-free diet.

@entity66 : a diverse clinical syndrome caused by intolerance of XXXX , @entity2247 and rye.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2247 :: ('4513', 'Species') :: ['barley'] @entity66 :: ('MESH:D004194', 'Disease') :: ['Coeliac disease', 'coeliac disease'] @entity8884 :: ('MESH:D008286', 'Disease') :: ['malabsorption'] @entity417 :: ('MESH:D000740', 'Disease') :: ['anaemia'] @entity174 :: ('MESH:D050723', 'Disease') :: ['low-impact bone fractures'] @entity706 :: ('MESH:D008223', 'Disease') :: ['small bowel lymphoma'] @entity170 :: ('MESH:D010024', 'Disease') :: ['osteoporosis'] @entity177 :: ('MESH:D051437', 'Disease') :: ['failure'] @entity509 :: ('MESH:C538429', 'Disease') :: ['hypoplasia'] @entity8265 :: ('7052', 'Gene') :: ['tissue transglutaminase'] @entity3505 :: ('4565', 'Species') :: ['wheat']
@entity3505 :: (4565,Species) :: ['wheat']
