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Previous Volume 356:2548-2549 June 14, 2007 Number 24 Next

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To the Editor: Celiac disease is a gluten-induced enteropathy, the treatment of which consists of permanently withdrawing dietary gluten. Adherence to diet is crucial for intestinal mucosal recovery, relief of symptoms, and prevention of intestinal T-cell lymphoma.¹ The amount of gluten needed to cause mucosal injury varies. Some patients can tolerate up to 5 g of gluten daily; others have intolerance after minimal exposure.

Two patients, both living in farming communities, were referred with nonresponsive celiac disease. Characteristics of the patients are shown in Table 1. Despite strict gluten-free diets, their symptoms and histologic changes persisted. Both were feeding . . . [Full Text of this Article]

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