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Commentary| Volume 365, ISSUE 6, P545-546, June 2023

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Celiac disease and mental health—A concealed association

      Celiac disease (CD), or celiac sprue, is a T-cell-mediated enteropathy that results from an immune reaction to gluten exposure in individuals with a genetic predisposition.
      • Therrien A.
      • Kelly C.P.
      • Silvester J.A.
      Celiac disease: extraintestinal manifestations and associated conditions.
      CD is considered a major public health concern, with an estimated global prevalence of 0.7% to 1.4%. In the modern era, the prevalence of CD has been rising in both the pediatric and adult populations owing to better recognition of the disease process as well as improvement in diagnostic testing methods.
      • Singh P
      • Arora A
      • Strand TA
      • et al.
      Global prevalence of celiac disease: Systematic review and meta-analysis.
      Clinical manifestations of celiac disease are highly variable, ranging from asymptomatic presentation to celiac crisis. Similarly, apart from the small bowel involvement, any organ might get involved in this disease process. Patients with CD often develop extraintestinal manifestations (EIM), and at times they could be the only symptom leading to a significant delay in the diagnosis. Extraintestinal manifestations result either from an immune-mediated response or from dietary deficiencies. Gluten-free diet (GFD) is the mainstay treatment in patients with CD. GFD also helps in resolving many of the EIM symptoms.
      • Therrien A.
      • Kelly C.P.
      • Silvester J.A.
      Celiac disease: extraintestinal manifestations and associated conditions.
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