Celiac disease--a continuous challenge.

Celiac disease (CD) is an immune mediated enteropathy with an increasing prevalence worldwide. It is estimated that 1% of general population in Europe is suffering from this ailment. The clinically silent form affects the majority of patients. Hence, diarrhea, nutritional deficiencies and weight loss are symptoms which are not very often seen. Nonspecific complaints like headaches and joint pain have the potential to delay the diagnosis. The high risk groups have been identified to be those patients suffering from autoimmune insulin-dependent diabetes mellitus, osteoporosis, Sjogren's syndrome and the first degree relatives of CD patients. Those patients should be screened for CD. The association of CD with several autoimmune ailments has various explanations ranging from common genotypes to systemic immune reactions triggered by food antigens. CD is, nevertheless, an autoimmune disorder triggered by an environmental antigen (gluten) but, as opposed to other autoimmune disorders in which the pathogenic process is self-sustained, the removal of gluten from diet results in relatively fast resolution of histological and serological markers.