Table 1 Definition of different states of celiac disease.
From: Celiac disease
States of celiac disease (CD) | Definition |
|---|---|
Clinically overt CD | Typical gastrointestinal symptoms and signs of malabsorption. Histological changes with villous atrophy and hypertrophic crypts (Marsh type-3 lesion, see table 2). |
Symptomatic (active) CD | Same findings as in clinically overt CD |
Silent CD | Asymptomatic patients with typical histological changes (Marsh type-3) |
Asymptomatic CD | Same findings as in silent CD |
Atypical CD | Extraintestinal findings such as IgA-nephropathy and neurological symptoms. Typical histological changes. |
Latent CD/potential CD | Subjects with genetic predisposition who have initially a normal histology with no atrophy or crypt hyperplasia. Immunological abnormalities such as increased count of IELs (particularly gamma-delta T cells, Marsh type-1) and positive EMA or tTG-antibody tests are sometimes present. These subjects may develop clinically overt CD later in life. |
Refractory CD | Patients who do not respond to a gluten-free diet or who previously responded but later become non-responsive to a gluten-free diet. Intestinal lymphoma may have developed. Inadvertent gluten ingestion and other diseases must be excluded (see differential diagnosis). |