1. A sudden worsening of the clinical state of an infant or child with celiac disease (gluten enteropathy) resulting from the ingestion of wheat germ-containing food, even in minute amounts, in those who are in the process of recovery on a gluten-free diet.
2. The rapid onset of malnutrition in celiac (abdominal) disease with severe watery diarrhea, vomiting, dehydration, and acidosis.

Vigorous antibiotic and nutritional therapy is required.