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Evidence-Based Medicine 2006;11:167; doi:10.1136/ebm.11.6.167
Copyright © 2006 by the BMJ Publishing Group Ltd.

EBM notebook

Evidently...

Richard Lehman, MRCGP, MA

Department of Primary Care, Oxford University
Oxford, UK

Key Words: 2011

The first 150 words of the full text of this article appear below.

In the second century CE (AD), the Greek physician Aretaeus wrote a description of chronic diarrhoea with malabsorption, calling it {delta}{iota}{alpha}{theta}{varepsilon}{sigma}{iota}{varsigma} {kappa}o{iota}{lambda}{iota}{alpha}{kappa}o{varsigma} ("coeliac diathesis"), which simply means something going wrong in the abdomen. Samuel Gee revived the term in 1888 and gave a classic description of children with diarrhoea, bloating, and wasting of unknown origin. One hundred years later, the cause (gluten) and the definitive diagnostic test (villous atrophy on small intestinal biopsy) were well established, but the prevalence was still thought to be about 1 in 1000. Then along came easily performed antibody assays, first to gliadin, then to endomysium, and most recently to transglutaminase, and it soon became apparent that the true prevalence of autoimmune disease due to gluten is about 1 in a 100. The clinical features are mostly non-specific and non-abdominal: typically tiredness and recurrent anaemia. Detecting it depends on having a low threshold for . . . [Full text of this article]


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