Each of the following is hallmark of celiac sprue except-
Celiac disease, also known as celiac sprue or gluten- sensitive enteropathy, is an immune mediated enteropathy triggered by ingestion of gluten containing cereals like wheat, rye, or barley. In adults, celiac disease manifests most commonly between the ages of 30 and 60. Some patients have silent celiac disease, defined as positive serology and villous atrophy without symptoms, or latent celiac disease, in which positive serology is not accompanied by villous atrophy. Symptomatic adult celiac disease is often associated with anemia (due to iron deficiency and, less commonly, B12 and folate deficiency), diarrhea, bloating, and fatigue. Pediatric celiac disease, which affects male and female children equally, may manifest with classic symptoms, typically between the ages of 6 and 24 months (after introduction of gluten to the diet) with irritability, abdominal distention, anorexia, diarrhea, failure to thrive, weight loss, or muscle wasting. Children with nonclassic symptoms tend to present at older ages with complaints of abdominal pain, nausea, vomiting, bloating, or constipation. A characteristic pruritic, blistering skin lesion, dermatitis herpetiformis, also is present in as many as 10% of patients, and the incidence of lymphocytic gastritis and lymphocytic colitis also is increased. Non invasive serological tests are done before biopsy. The most sensitive tests are the presence of IgA antibodies to tissue transglutaminase or IgA or IgG antibodies to deamidated gliadin. There is association of celiac disease with other immune diseases including type 1 diabetes, thyroiditis, Sjogren syndrome. ROBBINS TEXT BOOK OF PATHOLOGY 9TH EDITION PGNO. 577,578
It is a gluten-sensitive enteropathy
Most sensitive test is presence of IgA antibodies to tissue transglutaminase.
It is diagnosed on the basis of a small intestinal biopsy
It may be associated with diabetes insipidus
G.I.T