Celiac sprue is a common cause of malabsorption in Caucasians, especially those of European descent. The age of onset is variable, and ranges from the first year of life through the eighth decade. Almost all patients express the HLA-DQ2 allele. They are intolerant to foods containing gliadin.
Patients may malabsorb multiple nutrients or a single nutrient such as iron. Symptoms in severe cases can include diarrhea, steatorrhea, weight loss, anemia and osteopenia.
Skin manifestations (dermatitis herpetiformis) worsen considerably after ingestion of iodides (see avatar).
Diagnosis is established by measuring serum IgA antigliadin, IgA antiendomysial, and IgA anti-tTG antibodies, and, most importantly, by performing a biopsy of the small intestine.