Non-Responsive Celiac Disease due to Inhaled Gluten
Brief: This study evaluated two patients who had nonresponsive celiac disease after having been on a gluten free diet. Both patients still showed chronic symptoms and histological changes from celiac but had adhered to a strictly gluten-free diet. Both patients worked on farms where they feed gluten-containing grain to livestock on a daily basis and were likely inhaling dust particles with gluten in them, thereby aggravating their symptoms even when no gluten was being ingested with their diets. Wearing face masks greatly improved symptoms and histological results for both patients.

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http://content.nejm.org/cgi/content/short/356/24/2548