Clinical features of celiac disease today

The clinical spectrum of celiac disease has widened over the past decades. The condition is no longer a severe malabsorption syndrome. Instead, a typi cal celiac disease patient today has merely mild abdominal symptoms. Malabs orption can be subclinical or absent, and there is usually only moderate, i f any, loss of weight. Simultaneously, the current prevalence has increased from 1:1,000 to 1:300 inhabitants, or even higher. Clinically silent celia c disease cases are being detected in increasing numbers since the introduc tion and widespread use of serologic screening tests. Symptoms of celiac di sease can appear outside the intestine, a typical example being dermatitis herpetiformis. Gluten intolerance is no longer limited to overt: villous at rophy. Inflammation without villous damage maybe observed in genetically su sceptible individuals. The term latent celiac disease is applied in situati ons where the patient has normal villous architecture while an a gluten-con taining diet, but later develops small bowel villous atrophy compatible wit h celiac disease.