Although celiac disease (CD) is unrelated directly to the endocrine system, it still deserves mention owing to its close association with other autoimmune diseases, in particular type 1 diabetes and autoimmune thyroid disease. CD is an immune-mediated disease primarily of the small intestine but with a wide spectrum of clinical symptoms that is no longer isolated to the gastrointestinal tract. The classic presentation of CD occurs in a young child with growth failure, diarrhea, abdominal distension, and irritability shortly following the introduction of gluten in the diet. However, the clinical presentation of this disease has changed over the past decade, possibly as a result of both improved screening methods as well as the evolution of the natural disease course. Today’s celiac patient is often identified through screening due to a genetic risk for CD, who otherwise would not have sought medical attention for relatively minor symptoms if present at all.
Editor – Sweis and colleagues showed discrepancies between histology and serology in the diagnosis of coeliac disease (CD) (Clin Med August 2009 pp 346–8), and suggest we reduce our reliance on serology testing in diagnosing and excluding CD. However, we feel there are major reasons to
