Celiac disease is a chronic, immune-mediated condition in which genetically predisposed patients develop the disease in response to the introduction of dietary gluten.
Gluten is a general term for the water-insoluble proteins found in wheat, rye and barley. In susceptible people it leads to villous atrophy of the small intestine, which in turn causes malabsorption of nutrients. The disease runs from mechanism to consequence: a dietary protein meets the wrong genes, the immune attack it provokes flattens the absorptive surface of the bowel, and the effects — diarrhea, anemia, poor growth, bone loss — appear wherever the missing nutrients are needed.
The disease can be learned in its natural order, from mechanism to consequence and management:
- Pathogenesis of Celiac Disease — how gluten-derived gliadin peptides are modified by tissue transglutaminase and presented to intestinal T cells, and the genetic and environmental factors that shape the risk.
- Epidemiology of Celiac Disease — how often the disease occurs, why seropositivity outnumbers proven disease, and the geographic and ethnic patterns.
- Pathology of Celiac Disease — the mucosal changes seen on biopsy, why “villous atrophy” is a misnomer, and how the Marsh score grades them.
- Clinical Manifestations of Celiac Disease — the terms used to describe the forms of disease and the intestinal and extra-intestinal ways it presents at different ages.
- Conditions Associated with Celiac Disease — the disorders that cluster with celiac disease, most prominently dermatitis herpetiformis and other autoimmune conditions.
- Diagnosis of Celiac Disease — who to test, and how serology, HLA typing and duodenal biopsy are used together.
- Treatment of Celiac Disease — the gluten-free diet, the monitoring that confirms it is working, and the correction of deficiencies.
- Complications of Celiac Disease — the severe and long-term outcomes, including celiac crisis, refractory disease and intestinal lymphoma.
New to the topic, start with the pathogenesis and read in order; if you already know the disease and want the practical picture, the clinical manifestations and diagnosis give it directly.