ABSTRACT
A condition where the individual is intolerant to wheat products in the diet. Wheat contains water, starch, lipids, and the proteins albumin, globulins, and gluten. Gluten consists of gliadin and glutenine. The various proteins in wheat can cause different symptoms. One example is the so-called baker’s asthma in bakers allergic to wheat albumin. This reaction occurs when wheat dust is inhaled. In food allergy, globulins and glutenine are the most important allergens. Allergic reactions can occur following the ingestion of wheat. In celiac disease, an allergy to gliadin plays an important role in the pathogenesis. After exposure to gluten, infiltration of eosinophils and neutrophils, along with edema and an increase in vascular permeability of the mucosa of the small intestine, can be observed. If the allergic reaction is chronic, the infiltration consists mainly of lymphocytes and
plasma cells. Furthermore, flattening of the mucosal surface is found. The disorder manifests itself typically 6-12 months after introduction of gluten into the diet. It is characterized initially by intermittent symptoms such as abdominal pain, irritability, and diarrhea. If not treated, anemia, various deficiencies, and growth failure may occur as a result of malabsorption. Improvement is seen about 2 weeks after elimination of gluten from the diet. In addition to the immunological reaction to gluten, a direct toxic effect may also play a role in causing the disease.
