Celiac disease (also termed gluten-sensitive enteropathy) is a gluten-dependent immune-mediated disorder of the small intestinal mucosa. This disease occurs in genetically-predisposed individuals and serological studies in different populations estimate that about 1% of screen-positive individuals may eventually be diagnosed with celiac disease. However, a number of other disorders, labeled sprue-like intestinal disease, may also cause the pathological appearances of celiac disease, such as mucosal injury from oats or other proteins (eg., soy), along with a wide array of infections, including protozoans, viral, bacterial and parasitic agents. Some nutrient or vitamin deficiencies including zinc, folic acid and vitamin B12 along with an array of immune deficiency syndromes may cause a sprue-like enteropathy with the histopathological features of untreated celiac disease. None of these respond to a gluten-free diet. Instead, other forms of therapy may lead to resolution. Medications including pharmacological (eg., olmesartan) and biological agents (eg., checkpoint inhibitors) may cause sprue-like small intestinal disease. Ceasing use of the medication may lead to resolution of mucosal injury
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