Celiac sprue is a devastating disease that can have fatal consequences if untreated. Fortunately, if diagnosed correctly and promptly, it can be effectively treated with very satisfactory outcomes. A careful history will often suggest the diagnosis, but definitive diagnosis requires finding the typical lesion on small bowel biopsy and clinical improvement with a gluten-free diet. If symptoms and mucosal abnormalities persist, glucocorticoids should be tried. Malignancy is a rare complication of longstanding CS that should be looked for if there is no response to gluten withdrawal or if symptoms relapse despite adherence to diet.
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