Necropsy studies on adult coeliac disease.

The distribution of mucosal changes in adult coeliac disease have been studied in 24 cases within four hours of death. There were six patients on a normal diet who showed flat mucosa in the jejunum, convolutions in the middle third, and digitate villi in the terminal ileum. A more extensive distribution of flat mucosa and convolutions involving most of the small intestine was noted in one case. Eighteen patients had been treated with a gluten-free diet and 11 had responded well clinically and histologically. No evidence of flat mucosa was discovery at necropsy in six of these. Attention is drawn to the high incidence of malignancy in this series (13 out of 24 cases). Other complications of adult coeliac disease are discussed briefly.