Celiac disease classification: Difference between revisions
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==Classification== | ==Classification== | ||
Celiac disease (CD) may be classified according to burden of symptoms into five sub groups:<ref name="pmid14439871">{{cite journal |vauthors=RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC |title=Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue |journal=Gastroenterology |volume=38 |issue= |pages=28–49 |year=1960 |pmid=14439871 |doi= |url=}}</ref><ref name="pmid23022697">{{cite journal |vauthors=Zanini B, Caselani F, Magni A, Turini D, Ferraresi A, Lanzarotto F, Villanacci V, Carabellese N, Ricci C, Lanzini A |title=Celiac disease with mild enteropathy is not mild disease |journal=Clin. Gastroenterol. Hepatol. |volume=11 |issue=3 |pages=253–8 |year=2013 |pmid=23022697 |doi=10.1016/j.cgh.2012.09.027 |url=}}</ref><ref name="pmid1727768">{{cite journal |vauthors=Marsh MN |title=Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue') |journal=Gastroenterology |volume=102 |issue=1 |pages=330–54 |year=1992 |pmid=1727768 |doi= |url=}}</ref><ref name="pmid8783748">{{cite journal |vauthors=Troncone R, Greco L, Mayer M, Paparo F, Caputo N, Micillo M, Mugione P, Auricchio S |title=Latent and potential coeliac disease |journal=Acta Paediatr Suppl |volume=412 |issue= |pages=10–4 |year=1996 |pmid=8783748 |doi= |url=}}</ref><ref name="pmid17303598">{{cite journal |vauthors=Matysiak-Budnik T, Malamut G, de Serre NP, Grosdidier E, Seguier S, Brousse N, Caillat-Zucman S, Cerf-Bensussan N, Schmitz J, Cellier C |title=Long-term follow-up of 61 coeliac patients diagnosed in childhood: evolution toward latency is possible on a normal diet |journal=Gut |volume=56 |issue=10 |pages=1379–86 |year=2007 |pmid=17303598 |pmc=2000276 |doi=10.1136/gut.2006.100511 |url=}}</ref><ref name=" | Celiac disease (CD) may be classified according to burden of symptoms into five sub groups:<ref name="pmid14439871">{{cite journal |vauthors=RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC |title=Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue |journal=Gastroenterology |volume=38 |issue= |pages=28–49 |year=1960 |pmid=14439871 |doi= |url=}}</ref><ref name="pmid23022697">{{cite journal |vauthors=Zanini B, Caselani F, Magni A, Turini D, Ferraresi A, Lanzarotto F, Villanacci V, Carabellese N, Ricci C, Lanzini A |title=Celiac disease with mild enteropathy is not mild disease |journal=Clin. Gastroenterol. Hepatol. |volume=11 |issue=3 |pages=253–8 |year=2013 |pmid=23022697 |doi=10.1016/j.cgh.2012.09.027 |url=}}</ref><ref name="pmid1727768">{{cite journal |vauthors=Marsh MN |title=Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue') |journal=Gastroenterology |volume=102 |issue=1 |pages=330–54 |year=1992 |pmid=1727768 |doi= |url=}}</ref><ref name="pmid8783748">{{cite journal |vauthors=Troncone R, Greco L, Mayer M, Paparo F, Caputo N, Micillo M, Mugione P, Auricchio S |title=Latent and potential coeliac disease |journal=Acta Paediatr Suppl |volume=412 |issue= |pages=10–4 |year=1996 |pmid=8783748 |doi= |url=}}</ref><ref name="pmid17303598">{{cite journal |vauthors=Matysiak-Budnik T, Malamut G, de Serre NP, Grosdidier E, Seguier S, Brousse N, Caillat-Zucman S, Cerf-Bensussan N, Schmitz J, Cellier C |title=Long-term follow-up of 61 coeliac patients diagnosed in childhood: evolution toward latency is possible on a normal diet |journal=Gut |volume=56 |issue=10 |pages=1379–86 |year=2007 |pmid=17303598 |pmc=2000276 |doi=10.1136/gut.2006.100511 |url=}}</ref><ref name="pmid22197856">{{cite journal |vauthors=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 |title=European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease |journal=J. Pediatr. Gastroenterol. Nutr. |volume=54 |issue=1 |pages=136–60 |year=2012 |pmid=22197856 |doi=10.1097/MPG.0b013e31821a23d0 |url=}}</ref> | ||
*Classical | *Classical | ||
*Atypical | *Atypical | ||
Line 12: | Line 12: | ||
*Latent | *Latent | ||
*Potential CD | *Potential CD | ||
{| | |||
!Type | {|style="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
!Characteristics | !style="background: #4479BA; color: #FFFFFF; text-align: center;"|Type | ||
!style="background: #4479BA; color: #FFFFFF; text-align: center;"|Characteristics | |||
|- | |- | ||
|Classical | |style="padding: 5px 5px; background: #DCDCDC;" align="center" |Classical | ||
|Classic CD has typical feature of [[gastrointestinal]] symptoms and signs (eg, [[chronic diarrhea]]) and extraintestinal symptoms and signs (eg, [[Anemia|anaemia]], [[neuropathy]], [[decreased bone density]], increased risk of [[fractures]]) | |style="padding: 5px 5px; background: #F5F5F5;" align="center" |Classic CD has typical feature of [[gastrointestinal]] symptoms and signs (eg, [[chronic diarrhea]]) and extraintestinal symptoms and signs (eg, [[Anemia|anaemia]], [[neuropathy]], [[decreased bone density]], increased risk of [[fractures]]) | ||
|- | |- | ||
|Atypical | |style="padding: 5px 5px; background: #DCDCDC;" align="center" |Atypical | ||
|Atypical CD presents with minor [[gastrointestinal]] symptoms and signs and is associated with some rare manifestations, such as [[anemia]], dental enamel defects, [[osteoporosis]], [[arthritis]], increased [[transaminases]], neurological symptoms, or [[infertility]]. | |style="padding: 5px 5px; background: #F5F5F5;" align="center" |Atypical CD presents with minor [[gastrointestinal]] symptoms and signs and is associated with some rare manifestations, such as [[anemia]], dental enamel defects, [[osteoporosis]], [[arthritis]], increased [[transaminases]], neurological symptoms, or [[infertility]]. | ||
|- | |- | ||
|Asymptomatic | |style="padding: 5px 5px; background: #DCDCDC;" align="center" |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. | |style="padding: 5px 5px; background: #F5F5F5;" align="center" |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 | |style="padding: 5px 5px; background: #DCDCDC;" align="center" |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]]. | |style="padding: 5px 5px; background: #F5F5F5;" align="center" |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 | |style="padding: 5px 5px; background: #DCDCDC;" align="center" |Potential CD | ||
|Potential CD is defined by the presence of CD-specific [[antibodies]] and compatible [[HLA]] but without histological abnormalities in [[duodenal]] biopsies. The patient may or may not have symptoms and signs and may or may not develop a gluten dependent [[enteropathy]] later. | |style="padding: 5px 5px; background: #F5F5F5;" align="center" |Potential CD is defined by the presence of CD-specific [[antibodies]] and compatible [[HLA]] but without histological abnormalities in [[duodenal]] biopsies. The patient may or may not have symptoms and signs and may or may not develop a gluten dependent [[enteropathy]] later. | ||
|} | |} | ||
Revision as of 18:30, 12 September 2017
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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 burden of 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
- Atypical
- Asymptomatic
- Latent
- Potential CD
Type | Characteristics |
---|---|
Classical | Classic CD has typical feature of gastrointestinal symptoms and signs (eg, chronic diarrhea) and 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 associated with some rare manifestations, such as 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 in duodenal biopsies. The patient may or may not have symptoms and signs and may or may not develop a gluten dependent 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.