Celiac disease (sprue)

Alternative names:

celiac sprue; gluten enteropathy; nontropical sprue; sprue

Definition:

A disease in which the lining of the small intestine is damaged in response to ingestion of gluten and similar proteins, which are found in wheat, rye, oats, barley, and other grains including hybrid grains such as triticale.

Causes, incidence, and risk factors:

The exact cause of celiac disease is unknown. There is evidence that the disorder is inherited (its incidence is much higher in siblings). The disorder may be caused by an abnormal immune response to proteins found in grains, particularly gluten and the related protein gliadin. The intestines contain projections (called villi) which normally absorb nutrients. Celiac disease causes the villi to become flattened and lose the ability to absorb nutrients. Weight loss, anemia, and vitamin deficiencies may occur as a result of the malabsorption (inadequate absorption of nutrients from the intestinal tract).

Symptoms appear in babies within 6 months of introducing food containing gluten in the diet. The disease also affects children and adults approximately 1 out of 25,000 people. Risk factors are a genetic or familial tendency toward the disease. The disorder is most common in Caucasians of northern and southern European ancestry, and approximately 70% of reported cases occur in women.

Diseases that can be associated with celiac disease include lactose intolerance, dermatitis herpetiformis (a burning, itching, blistering rash), insulin dependent diabetes mellitus (IDDM), systemic lupus erythematosus, thyroid disease, and autoimmune disorders.