Extending the Scope in Celiac Disease

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Abstract
A century has passed since Samuel Gee's description of the "coeliac affection."1 A definitive break-through in this disease came about 40 years ago with the recognition that the elimination of dietary gluten (in wheat, rye, barley, and oats) could reverse the clinical manifestations. About a decade later, peroral suction biopsy of the small intestine established that patients with the disease have a characteristic, albeit not entirely specific, "flat," or avillous, mucosal lesion. It has since become evident that celiac disease (also called celiac sprue or gluten-sensitive enteropathy) has a broad clinical spectrum and may present with more subtle manifestations than . . .