4.5 Article

What are the clinical consequences of 'potential' coeliac disease?

期刊

DIGESTIVE AND LIVER DISEASE
卷 55, 期 4, 页码 478-484

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2022.10.019

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Coeliac disease; Gluten -free diet; Potential coeliac disease

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This study compared the clinical presentation of potential coeliac disease (PCD) with coeliac disease (CD). The findings showed that PCD patients had fewer extraintestinal manifestations and less haematinic deficiencies compared to CD patients. It was also observed that a gluten-free diet improved symptoms in PCD patients.
Background: There is limited data on the clinical consequences of potential coeliac disease (PCD).Aim: To compare the presentation of PCD with coeliac disease (CD). Methods: A retrospective study of adult PCD patients ( > 18 years) was performed. Presenting manifes-tations, serology and HLA-DQ genotyping were compared to an age-at-diagnosis and sex-matched CD cohort.Results: The PCD cohort comprised 84 patients (median age 37 years, 63% female). The majority of PCD patients were symptomatic at presentation (PCD 91.7% versus CD cohort 94.0%, p = 0.55). In total, 79.8% and 76.2% of the PCD and CD cohorts respectively reported >= 1 gastrointestinal symptoms at presentation ( p = 0.58 ). Extraintestinal presentation was less common in PCD than CD (65.5% versus 79.8% respectively, p = 0.038). PCD patients had fewer haematinic deficiencies than those with CD (iron 21.4% versus 41.7%, p = 0.005, vitamin D 14.3% versus 27.4%, p = 0.037 and folate deficiency 7.1% versus 28.6%, p = < 0.001.) Post-diagnosis, 67.5% of the PCD patients chose a GFD. One-third of the patients who continued to eat gluten developed villous atrophy.Conclusion: The presentation of PCD and CD differ; however, mild enteropathy does not necessarily equate to mild symptoms. The GFD appears to be advantageous in symptomatic PCD.(c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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