gluten-sensitive enteropathy


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gluten-sensitive enteropathy

coeliac disease

A malabsorptive syndrome caused by hypersensitivity of intestinal mucosa to alpha-gliadin, a gluten extract composed of glutamine and proline-rich proteins that is found in wheat, barley, rye, and oats.
 
Clinical findings
Diarrhoea, copious fatty stools, abdominal distension, weight loss, haemorrhage, osteopenia, muscle atrophy, peripheral neuropathy, CNS and spinal cord demyelination (sensory loss, ataxia), amenorrhoea, infertility, oedema, petechiae, dermatitis herpetiformis (especially if HLA B27), alopecia areata. Occult bleeding occurs in half of patients.
 
Lab
Transaminases (ALT, AST) are increased in ± 40% of patients with CD, which usually normalises with a gluten-free diet; iron deficiency, anaemia due to occult bleeding.

Diagnosis
Duodenal biopsy; anti-gliadin and anti-endomysial antibodies.
 
Management
Eliminate gliadin from diet.

Prognosis
Without treatment, 10–15% develop lymphoma (e.g., immunoblastic lymphoma; less commonly, T cell lymphoma), a risk that increases with disease duration. CD predisposes to gastrointestinal lymphoma and carcinoma of the oral cavity and oesophagus; the otherwise rare small intestinal adenocarcinoma is 80-fold more common in CD.
References in periodicals archive ?
Gluten-sensitive enteropathy is most common in the northern hemisphere but also occurs in South America, Australia and New Zealand.
Neutrophilic infiltration in gluten-sensitive enteropathy is neither uncommon nor insignificant: assessment of duodenal biopsies from 267 pediatric and adult patients.
Celiac disease, also known as gluten-sensitive enteropathy, is a food intolerance that affects individuals with a genetic predisposition to react to gliadin, a gluten protein found in wheat, barley, and rye.
Gluten-sensitive enteropathy (GSE)[3] is a common chronic small-bowel disorder of autoimmune origin occurring in both children and adults.
Celiac disease, also known as gluten-sensitive enteropathy, celiac sprue, or nontropical sprue (see reference for terminology) is a common immune-mediated disorder characterized by chronic inflammation of the small intestine, and the presence of systemic manifestations, which occurs in genetically predisposed individuals on consumption of certain grains, including wheat.
Also known as celiac sprue or gluten-sensitive enteropathy, celiac disease has a worldwide distribution.
Collagenous sprue is a rare enteropathy that shares some clinical and histologic features with gluten-sensitive enteropathy (celiac disease).
Celiac disease, also known as celiac sprue, nontropical sprue, gluten-induced enteropathy, or gluten-sensitive enteropathy (GSE), is a chronic inflammatory disorder of the small intestine characterized by malabsorption after ingestion of wheat gluten or related proteins in rye (secalins) and barley (hordeins) in individuals with a certain genetic background.