Bibliography Trier JS . N Engl J Med. Lerner A, Kumar V, Ianu TC . Clin Exp Immunol. The most prominent such disease is celiac sprue or gluten-sensitive enteropathy.
Celiac sprue is more frequent in diabetics.
The clinical spectrum of celiac sprue varies from asymptomatic histologic abnormalities to severe malabsorption. Iron deficiency may occur from both malabsorption and occult blood loss. The findings of antigliadin, antiendomysial, and antireticulin antibodies are suggestive but not diagnostic. The diagnosis can be confirmed by a small-bowel biopsy specimen showing characteristic villus blunting and crypt elongation that improves or resolves when dietary gluten is withdrawn. If the diagnosis is in doubt, a gluten challenge will reproduce the biopsy abnormalities.