[Celiac disease--a diagnostic and therapeutic challenge].

The actual prevalence of celiac disease in the Finnish adult population is already more than 2%. By using sensitive and precise celiac disease antibody tests it is possible to find the correct patients for further investigations. The diagnosis is still based on the gluten-induced villous atrophy found in a biopsy of the small intestine, but celiac disease begins before the development of villous damage. Elevated levels of anti-endomysium or anti-tissue transglutaminase antibodies in a patient with normal intestinal villi are indicative of a developing celiac disease. On a perpetual gluten-free diet, patients remain asymptomatic and capable of working and functioning.