June 1966

Variable Clinical Course of Adult Celiac Disease

Author Affiliations


From the Gastrointestinal Section (Kinsey-Thomas Foundation), Medical Clinic, Hospital of the University of Pennsylvania, Philadelphia.

Arch Intern Med. 1966;117(6):789-794. doi:10.1001/archinte.1966.03870120053011

AS a challenge to diagnostic acumen and as a potential therapeutic triumph, adult celiac disease is unexcelled in gastroenterology. The entity adult celiac disease may be defined as a disease of unknown etiology characterized by a grossly flat jejunal lining and a typical microscopic lesion which improves when gluten is removed from the diet. The disease as we know it in the continental United States has had a long and interesting history. According to Hanes and McBryde,1 the term "sprouw" was first used by Vincent Ketelaer in 1669 to describe aphthous stomatitis occurring in Belgians and associated with copious amounts of feces. Hillary described the entity "tropical sprue" in 1759, and for many years thereafter it was considered to be peculiar to those areas of the world. Thaysen 2 popularized the concept of a similar entity occurring in temperate climates in the early 1930's. Meanwhile a similar syndrome in

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