What is 'Potential' Celiac Disease?

Celiac.com 07/01/2013 - Potential celiac disease (PCD) is a type of celiac disease marked by positive endomysial/tissue transglutaminase antibodies and a preserved duodenal mucosa despite a gluten-containing diet (GCD). PCD can turn into active celiac disease, but very little is currently known about what causes that to happen.

A team of researchers recently conducted a retroactive study to better understand PCD rates and the natural history of adult patients with PCD.

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The research team included F. Biagi, L. Trotta, C. Alfano, D. Balduzzi, V. Staffieri, P.I. Bianchi, A. Marchese, C. Vattiato, A. Zilli, O. Luinetti, P. Gobbi, and G.R. Corazza of the Celiac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and the University of Pavia in Pavia, Italy.

For their study, the team assessed the clinical notes for all 47 patients with PCD attending our clinic between September 1999 and October 2011. They established a control group of patients with active celiac disease, randomly selected and matched for sex and date of birth.

They then compared results for symptoms, associated diseases, familiarity, and laboratory data at diagnosis for the PCD group against results from the control group. They found that 42 of 187 celiac disease patients directly diagnosed at their center had PCD. That's 1 out of every 4.4 celiac patients, 18.3%, with a 95% confidence interval (CI) 13.3-23.4%.

There was no difference between the two groups in terms of average age at diagnosis, laboratory data, prevalence of symptoms, associated diseases, and familiarity for celiac disease.

Interestingly, some patients with PCD maintained a normal duodenal mucosa for many years and their symptoms spontaneously improved despite continuing to regularly consume gluten. Basically, this study indicates that potential celiac disease is not a rare and/or early form of celiac disease.

Because of the consistency in age at diagnosis and clinical features between potential celiac disease and active celiac disease, they suggest that potential celiac disease is a separate condition that can only develop into active celiac disease, though it does not always do so.

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