Celiac disease classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Celiac disease (CD) may be classified according to the symptoms and laboratory findings into 5 sub groups as, classical, atypical, asymptomatic, latent, and potential CD.
Classification
Celiac disease (CD) may be classified according to burden of symptoms into five sub groups:[1][2][3][4][5][6]
- Classical CD
- Atypical CD
- Asymptomatic CD
- Latent CD
- Potential CD
| Type | Characteristics |
|---|---|
| Classical | Classic CD has typical features of gastrointestinal upset (eg, chronic diarrhea) in addition to extraintestinal symptoms and signs (eg, anaemia, neuropathy, decreased bone density, increased risk of fractures) |
| Atypical | Atypical CD presents with minor gastrointestinal symptoms and signs and is rarely associated with anemia, dental enamel defects, osteoporosis, arthritis, increased transaminases, neurological symptoms, or infertility. |
| Asymptomatic | Silent CD is defined as the presence of positive CD-specific antibodies, HLA, and small-bowel biopsy findings that are compatible with CD but without sufficient symptoms and signs to warrant clinical suspicion of CD. |
| Latent | Latent CD is defined by the presence of compatible HLA but without enteropathy in a patient who has had a gluten-dependent enteropathy at some point in his or her life. The patient may or may not have symptoms and may or may not have CD-specific antibodies. |
| Potential CD | Potential CD is defined by the presence of CD-specific antibodies and compatible HLA but without histological abnormalities on duodenal biopsies. The patient may or may not have symptoms and signs and may or may not develop a gluten dependency enteropathy later. |
References
- ↑ RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC (1960). "Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue". Gastroenterology. 38: 28–49. PMID 14439871.
- ↑ Zanini B, Caselani F, Magni A, Turini D, Ferraresi A, Lanzarotto F, Villanacci V, Carabellese N, Ricci C, Lanzini A (2013). "Celiac disease with mild enteropathy is not mild disease". Clin. Gastroenterol. Hepatol. 11 (3): 253–8. doi:10.1016/j.cgh.2012.09.027. PMID 23022697.
- ↑ Marsh MN (1992). "Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue')". Gastroenterology. 102 (1): 330–54. PMID 1727768.
- ↑ Troncone R, Greco L, Mayer M, Paparo F, Caputo N, Micillo M, Mugione P, Auricchio S (1996). "Latent and potential coeliac disease". Acta Paediatr Suppl. 412: 10–4. PMID 8783748.
- ↑ Matysiak-Budnik T, Malamut G, de Serre NP, Grosdidier E, Seguier S, Brousse N, Caillat-Zucman S, Cerf-Bensussan N, Schmitz J, Cellier C (2007). "Long-term follow-up of 61 coeliac patients diagnosed in childhood: evolution toward latency is possible on a normal diet". Gut. 56 (10): 1379–86. doi:10.1136/gut.2006.100511. PMC 2000276. PMID 17303598.
- ↑ Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP (2012). "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease". J. Pediatr. Gastroenterol. Nutr. 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856.