Another step towards celiac screening.

Abstract

In 1888, Samuel Gee1 described a disorder of chronic maldigestion and malabsorption that affected individuals of all ages, particularly children 1 to 5 years of age, that he termed, “coeliac affection.” Although he did not know the exact cause, he aptly suspected that the treatment was some form of dietary restriction, with a reduced allowance of “farinaceous foods,” rich in starch or flour. More than a century later, we understand that celiac disease is an increasingly common disorder that occurs when genetically susceptible individuals are exposed to gluten, resulting in immune-mediated inflammation of the small bowel and a variety of clinical manifestations that need not be limited to the gastrointestinal tract. As recently as 30 years ago, the disorder was thought to be relatively uncommon. In the 1980s, discovery of celiac-related antibodies and their use in serologic screening led to the identification of asymptomatic and mildly symptomatic cases. With current screening, the incidence approaches 1% of the general North American population, with higher frequencies … Address correspondence to Richard J. Noel, MD, PhD, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Duke University Medical Center 102375, Durham, NC 27710. E-mail: richard.noel{at}dm.duke.edu