¿Doctor, porqué soy celíaco si soy mexicano? Rompiendo un paradigma más de la enfermedad celíaca en México

In medicine, a paradigm is a model or a theory that provides an integrated explanation of the processes of health and disease. Paradigms establish what is ‘‘normal’’ or legitimate as knowledge and intervention, while being coherent with current understanding. A paradigm’s condition of dominant or hegemonic validity, of almost absolute acceptance by the respective community or society, as well as by its transmitters and practitioners, is characteristic. New generations are educated under that paradigm and society itself is organized based on its principles, hence the official and coercive nature of its presence. In medicine, to challenge or ‘‘break’’ a dominant paradigm is a risk that can involve crisis, revolution, or changes in the way diagnoses are made and treatments are established. In the case of celiac disease (CD), also known as celiac sprue or gluten-sensitive enteropathy, a disease that causes varying degrees of damage to the mucosa of the small bowel in genetically susceptible individuals, paradigms have been broken in the past decade in our country. In Mexico, CD had traditionally been considered a rare pathology, almost exclusive to certain racial groups, mainly to individuals directly descended from Europeans, who are the more frequent carriers of the genes associated with CD. Genetic susceptibility is conferred by the HLA-DQ2 histocompatibility allele with the typical DQA1*0501/DQB1*0201 heterodimer, present in 95% of the individuals with CD, and