- a.k.a gluten sensitive enteropathy
- caused by an immunological reaction to gliadin fraction of wheat and other cereals
- 95% HLA DQ2 and HLA DQ8
- gliadin provokes an inflammatory response which results in partial or total villous atrophy in proximal small bowel
- presents with diarrhea, oral ulcer, weight loss, growth retardation, abdominal pain and anemia
- associated with dermatitis herpetiformis and IgA deficiency
- increased risk of all GI malignancy, especially small bowel lymphoma and esophageal CA
- diagnosis by IgA anti-endomysial antibodies
- duodenal/jejunal biopsy shows hypertrophied crypts of Lieberkuhn, villous atrophy, degenerated surface epithelial cells and increase in intraepithelial lymphocytes
- treatment:gluten free diet
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