Histopathological diagnosis of gluten-sensitive enteropathy

As the prevalence rate of gluten-sensitive enteropathy (GSE) may reach 1:99-1:133 in both Europe and North America, there is an increased recognition of 'silent' GSE in patients complaining of fatigue alone, presenting with mild anaemia or subtle delays in growth in children. Small bowel biopsies can either confirm or suggest the diagnosis when the presentation is atypical. Microscopic evaluation of the mucosa is also important to monitor adherence to the gluten-free diet and detect complications, especially gastrointestinal neoplasms such as intestinal T-cell lymphoma.