A Case of Diarrhea, Ataxia, and Capsule Endoscope Retention

Excerpt

Celiac disease, otherwise known as celiac sprue, is an autoimmune enteropathy triggered by the ingestion of gluten-containing grains. It is evident that, in genetically susceptible individuals, the presence of ingested gluten triggers an inappropriate T-cell response which leads to mucosal inflammation and injury of the small intestine [1]. In some affected individuals, the immune response to gluten extends beyond the intestinal tract, resulting in a variety of associated conditions such as dermatitis herpetiformis, peripheral neuropathy, and cerebellar ataxia [1]. In the United States celiac disease has historically been thought of as a rare disorder; however, it is now known that celiac sprue is quite common and is estimated to affect ∼1% of the population [2]. The recent increase in prevalence of celiac sprue is mainly attributable to newly developed serological tests for the disease and the recognition that a significant proportion of affected patients present with symptoms other than diarrhea [1]. However, controversy remains regarding the optimal approach to diagnosis of this disease, specifically with regard to serologic testing and methods for obtaining tissue for histologic evaluation. …