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Nutrients. 2019 Feb 1;11(2). pii: E320. doi: 10.3390/nu11020320.

Gluten-Induced Extra-Intestinal Manifestations in Potential Celiac Disease-Celiac Trait.

Author information

1
University of Medicine and Pharmacy "Carol Davila" and National Institute for Mother and Child Health "Alessandrescu-Rusescu", Bucharest 020395, Romania. alina.popp@uta.fi.
2
Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, 33520 Tampere, Finland. alina.popp@uta.fi.
3
Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, 33520 Tampere, Finland. markku.maki@uta.fi.

Abstract

Celiac disease patients may suffer from a number of extra-intestinal diseases related to long-term gluten ingestion. The diagnosis of celiac disease is based on the presence of a manifest small intestinal mucosal lesion. Individuals with a normal biopsy but an increased risk of developing celiac disease are referred to as potential celiac disease patients. However, these patients are not treated. This review highlights that patients with normal biopsies may suffer from the same extra-intestinal gluten-induced complications before the disease manifests at the intestinal level. We discuss diagnostic markers revealing true potential celiac disease. The evidence-based medical literature shows that these potential patients, who are "excluded" for celiac disease would in fact benefit from gluten-free diets. The question is why wait for an end-stage disease to occur when it can be prevented? We utilize research on dermatitis herpetiformis, which is a model disease in which a gluten-induced entity erupts in the skin irrespective of the state of the small intestinal mucosal morphology. Furthermore, gluten ataxia can be categorized as its own entity. The other extra-intestinal manifestations occurring in celiac disease are also found at the latent disease stage. Consequently, patients with celiac traits should be identified and treated.

KEYWORDS:

celiac trait; early developing celiac disease; extra-intestinal manifestations; genetic gluten intolerance; gluten; latent celiac disease; mild enteropathy; natural history; potential celiac disease

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