RT Book, Section A1 Patel, Priti N. A1 Mangione, Robert A. A2 DiPiro, Joseph T. A2 Yee, Gary C. A2 Posey, L. Michael A2 Haines, Stuart T. A2 Nolin, Thomas D. A2 Ellingrod, Vicki SR Print(0) ID 1182439695 T1 Celiac Disease T2 Pharmacotherapy: A Pathophysiologic Approach, 11e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781260116816 LK accesspharmacy.mhmedical.com/content.aspx?aid=1182439695 RD 2024/03/29 AB KEY CONCEPTSCeliac disease is a chronic, small intestinal immune-mediated enteropathy caused by intolerance to gluten found in wheat, barley, rye, and other foods when a genetically predisposed person is exposed to the environmental trigger, gluten.The prevalence of celiac disease is 0.7% in America and appears to be increasing in prevalence worldwide.The integrity of the tissue junctions of the intestinal epithelium is compromised in patients with celiac disease; this enables gluten to reach the lamina propria. The presence of gluten in the lamina propria and an inherited combination of genes contribute to the heightened immune sensitivity to gluten that is found in patients with celiac disease.The classic presenting symptom is diarrhea, which may be accompanied by abdominal pain or discomfort; however, it is noteworthy that during the past decade diarrhea has been reported as the main presenting symptom of celiac disease in less than 50% of cases.Dermatitis herpetiformis is a skin manifestation of small intestinal immune-mediated enteropathy caused by exposure to dietary gluten.The frequency of diagnosis of patients with celiac disease has increased; however, the majority of patients with this condition remain undiagnosed.The confirmation of a diagnosis of celiac disease should be based on a combination of findings from the medical history, physical examination, serology, and duodenal biopsy. The recommended serologic marker that is used for screening patients is serum antitissue transglutaminase antibody.Strict, lifelong adherence to a gluten-free diet is the only treatment for celiac disease that is currently available.Clinicians must evaluate the patient with celiac disease for nutritional deficiencies (including folic acid, vitamin B12, fat-soluble vitamins, iron, and calcium) due to malabsorption.