What happens to a celiac when he/she ingests gluten while on a gluten-free diet?

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Why does it often seem like small and large doses of gluten cause the same type and severity of symptoms? Why is gluten exposure not dose related?

(Source: Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital: FAQs)

“Celiac disease (CD) is an autoimmune condition that leads to changes in the immune system in genetically predisposed people upon exposure to gluten. This condition causes intestinal inflammation and gastrointestinal symptoms.

“Studies have looked at determining the safe levels of gluten exposure. The lowest amount of daily gluten that causes damage to the celiac intestinal mucosa over time (the gluten threshold) is 10 to 50 mg per day (a 25-g slice of wheat bread contains approximately 1.6 g of gluten). The Codex Alimentarius regulation and the Food and Drug Administration both endorse a maximum gluten contamination of <20 ppm (parts per million) in a gluten-free product. Under twenty ppm is considered a safe threshold even for patients who eat large amounts of wheat/gluten substitutes.

“Once the amount of gluten intake crosses this threshold, the severity of gastrointestinal symptoms and intestinal damage is independent of the quantity of gluten intake. The chain of inflammatory events that are activated once the threshold is passed is independent of the amount of gluten. This phenomenon is not completely understood.”