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Other laboratory abnormalities include macrocytic anaemia due to folate (or, rarely, vitamin B 12 ) deficiency, coagulopathy resulting from vitamin K deficiency, or vitamin D deficiency leading to hypocalcaemia and an elevated alkaline phosphatase level.[8] Other increasingly recognised extra intestinal manifestations include bone fractures,[9] infertility,[10] psychiatric syndromes,[11] and various neurologic conditions, including peripheral neuropathy, ataxia, and seizures.[12] Autoimmune diseases occur more commonly in patients with coeliac sprue, especially type 1 diabetes mellitus[13] and autoimmune thyroiditis.[14] The prevalence of coeliac sprue in patients with type 1 diabetes is approximately 3 to 8 percent.[15] Comment The incidence of CD is increasing across all age ranges and yet remains grossly underdiagnosed

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