Clinical practice. Celiac disease.

Copyright © 2012 Massachusetts Medical Society. A 22-year-old woman fractures her wrist while playing volleyball. She reports a history of fatigue and intermittent oral ulcerations but no other symptoms. Radiography of her wrist shows osteopenia. Laboratory testing is notable for a hematocrit of 32% and low levels of ferritin and 25-hydroxyvitamin D. Although she reports no gastrointestinal symptoms, celiac disease is suspected. How should she be further evaluated and, if testing indicates celiac disease, how should her case be managed?

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