The Many Faces of Celiac Disease

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Abstract
The report by Fine in this issue of the Journal, 1 which describes frequent positive tests for occult intestinal bleeding among patients with celiac disease, adds a new dimension to our understanding of this disorder. Celiac disease can be overt, with the classic features of diarrhea, weight loss, and generalized malnutrition, or subclinical, with isolated nutrient deficiencies but no gastrointestinal symptoms. This disorder affects as many as 1 in 300 people of European descent, in whom it is associated with the HLA-DR3 gene and several other class II haplotypes of the major histocompatibility complex, but it is rare to nonexistent among . . .

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