Celiac sprue (the great modern-day imposter)

Purpose of review To review the current epidemiological information on celiac disease and the various presentations and associated. Recent findings Epidemiologic studies reveal celiac disease to be common occurring in approx. 1% of the population. It is being diagnosed worldwide, even in developing countries. The classic mode of presentation has become less common with diarrhea or a malabsorption syndrome as the mode of presentation in fewwer than 50% of individuals. The other majormodes of presentation are iron-deficiency anaemia, osteoporosis, screening of family members, or incidentally at endoscopy done for dyspepsia or reflux. Neurological presentations may include peripheral neuropathy or ataxia. Arthritis is commonly found in patterns with celiac disease when systematically sought. Patients often have a previous diagnosis of irritable bowel syndrome. Autoimmune diseases occur more frequently (three to ten times more) in those with celiac disease than the general population. However, this increased incidence of autoimmune diseases is not prevented by early diagnosis of celiac disease. Summary We will reveiw the various associated/preentations of celiac disease. The heterogeneity of the symptoms can make the diagnosis challenging and certainly the great modern day imposter.