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Latent and potential coeliac disease
1Department of Pediatrics, University Federico II, Naples, Italy.
Summary
Coeliac disease (CD) encompasses silent, latent, and potential forms. Potential CD involves immunological abnormalities without prior biopsy evidence of overt disease, distinguishing it from latent and silent CD.
Area of Science:
- Gastroenterology
- Immunology
- Pathology
Background:
- Coeliac disease (CD), or gluten-sensitive enteropathy, has recently introduced new classifications: silent, latent, and potential CD.
- Silent CD presents with severe jejunal damage but no symptoms.
- Latent and potential CD feature normal-appearing jejunal mucosa on a gluten-containing diet.
Purpose of the Study:
- To clarify the distinctions between silent, latent, and potential coeliac disease.
- To identify key diagnostic markers for these CD classifications.
Main Methods:
- Review of existing literature and diagnostic criteria for coeliac disease subtypes.
- Analysis of clinical, immunological, and histopathological features associated with each CD classification.
Main Results:
- Silent CD shows severe jejunal damage without symptoms.
- Latent CD may have a history of villous atrophy that resolved with a gluten-free diet and can be symptomatic.
- Potential CD is characterized by immunological abnormalities (e.g., endomysial antibodies, increased intraepithelial lymphocytes) without a history of overt CD biopsy findings.
Conclusions:
- Distinguishing between silent, latent, and potential CD is crucial for accurate diagnosis and management.
- Elevated endomysial antibodies and increased intraepithelial lymphocytes are significant indicators, particularly for potential CD progression.
- Further research may refine diagnostic criteria and understanding of these CD variants.