Celiac sprue.

Abstract

ELIAC sprue, also known as celiac disease and gluten-sensitive enteropathy, is characterized by malabsorption resulting from inflammatory injury to the mucosa of the small intestine after the ingestion of wheat gluten or related rye and barley proteins. There is clinical and histologic improvement on a strict gluten-free diet, and relapse when dietary gluten is reintroduced. 1 Accounts of celiac sprue date back to the first century A . D . 2 It was not until the 1940s, however, that the link to gluten ingestion was established; Dicke, a Dutch pediatrician, observed that the condition of children with celiac sprue improved during the food shortages of World War II, only to relapse after cereal supplies were restored. 3 Until fairly recently, celiac sprue was considered uncommon in the United States, with an estimated prevalence of 1 per 3000 population. 4 However, greater awareness of its presentations and the availability of new, accurate serologic tests have led to the realization that celiac sprue is relatively common, affecting 1 of every 120 to 300 persons in both Europe 5-7 and North America. 8