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| Gluten-Sensitive Enteropathy |
| Etiology • Unknown. |
| Pathogenesis • Gliadin, a protein component of gluten, found in wheat, oats, barley and rye. • Anti-endomysin antibody and anti-gliadin (AGA) antibodies • Gamma-delta TCR (T-cell-receptor)-bearing intraepithelial lymphocytes present in increased numbers (? response to antigen-antibody complex), |
| Epidemiology • Generally in Caucasians. • Prevalence: 1 in 2000-3,000 • Associated with HLA-DR3 and HLA-DQw2 • Concordance of 70% in identical twins. |
| General Gross Description • Flattened mucosal surface |
| General Microscopic Description • Loss of villus architecture • Intraepithelial lymphocytes • Increased plasma cells and lymphocytes in lamina propria • Diffuse process, more severe in proximal portion of small bowel. |
| Clinical Correlation • Malabsorption including diarrhea, flatulence, weight loss and fatigue. • Often present in infancy but may not present into adulthood • Excellent clinical and pathologic response to gluten free diet |
| References • Diagnostic Surgical Pathology, 2d edition, Sternberg SS (ed). Philadelphia: Lippincott-Raven,1996, pp. 1313. • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 797-8. |
| Gluten-Sensitive Enteropathy |
| Synopsis by: Melinda Sanders M.D. (T64000D62180)[529] |
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