A 4-year-old girl is brought to the physician because her parents noticed that she has been having pale, fatty, foul-smelling stools. The patient is at the 50th percentile for height and 10th percentile for weight. Her symptoms respond dramatically to a gluten-free diet. Which of the following is the most likely diagnosis?

Celiac sprue, which is also referred to as gluten-sensitive enteropathy, is characterized by (1) generalized malabsorption, (2) small intestinal mucosal lesions, and (3) prompt clinical and histopathologic response to the withdrawal of gluten-containing food. Critical factors in the development of celiac sprue include genetic predisposition and gliadin exposure. The hallmark of celiac disease is a flat mucosa, with blunting of villi, damaged epithelial cells, intra-epithelial T cells, and increased plasma cells in the lamina propria. The other choices do not respond to a gluten-free diet.Diagnosis: Celiac sprue