Celiac disease and nonceliac gluten sensitivity

Celiac disease (CD) is an increasingly common chronic autoimmune disease caused by permanent gluten sensitivity that occurs in people carrying the HLA-DQ2 or HLA-DQ8. It causes both gastroenteropathy (demonstrated by duodenal biopsy) and extraintestinal pathologic conditions (Fig 1A and B). The disease is often diagnosed by the discovery of positive autoantibodies (anti–tissue transglutaminase [anti-tTG] IgA and anti–endomysial antibody [EMA] IgA) in a patient, which might trigger an intestinal biopsy that reveals villous atrophy.

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