PMC

Overview of individuals with latent CD. *Three individuals were suspected to have reduced the amount of dietary gluten prior to biopsy (due to other family member with CD). A fourth individual had abstained from gluten at an earlier stage but consumed a normal diet at time of biopsy. The most common reason for misclassification was presence of an earlier unrecorded biopsy with villous atrophy (6.1%).

Identification of individuals with latent CD. By linkage of biopsy registers and CD serology registers we identified 40,250 individuals with normal mucosa (and no biopsy record of CD or inflammation) with at least one test for CD serology. 7,324 had at some stage a positive CD serology. Some 50% of these (N = 3,736) had a positive CD serology at time of biopsy. 3,285 (87.9% of individuals with latent CD) had positive IgA, while 451 had positive IgG CD serology. Of 3,736 individuals with latent CD, 228 had positive IgA EMA; 3,117 had positive IgA AGA; and 161 had positive IgA TTGA. IgG EMA 1; IgG AGA 491; IgG TTGA 4. Due to overlap this exceeds 3,736). 303 individuals with IgA AGA had at least 2 positive IgA AGA values within the stipulated time frame (≥2 positive tests: IgG AGA 164; IgA TTGA 10).