Abstract
Celiac disease is an intestinal inflammatory disease due to gluten intake in genetically predisposed persons (HLA DQ2/DQ8). Its prevalence is estimated to be about 1/100 in Europe and the USA. Celiac disease is extremely variable, sometimes presenting as iron-deficiency anemia, or as recurring aphthous stomatitis or amenorrhea or osteo-arthritis as the only presenting complaints. Diagnosis relies on histological evidence of villous atrophy in the proximal small bowel and the presence of specific serum antibodies. Treatment relies on avoidance of alimentary gluten (wheat, rye, barley). A gluten-free diet can prevent the development of malignant complications such as small bowel adenocarcinomas or lymphomas and osteopenia. The main cause of failure of a gluten-free diet is poor observance. If this is not the case, serious complications of celiac disease, such as clonal refractory celiac disease and intestinal T-cell lymphoma, should be suspected. The principal current therapeutic challenges are to find alternatives to the gluten-free diet and new effective treatment of lymphomatous complications.
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