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Latent Celiac Disease Afflicts Many Who Tolerate Gluten

Celiac.com 11/08/2007 - A team of doctors led by Christophe Cellier from the Hopital European Georges Pompidou in Paris examined a group people who were diagnosed with celiac disease as children and who tolerated the introduction of gluten into their diets, and continued to consume gluten into their adult years.

A total of 61 patients were evaluated with a bowel biopsy. 13 of the subjects exhibited no indications of the disease, a condition known as latent celiac disease. 48 of the patients without symptoms showed celiac-related intestinal damage, a condition known as silent celiac disease.

The study team observed that a similar ratio of patients with both latent celiac and silent celiac disease exhibited minor symptoms of celiac disease. Both patients with symptoms and those without symptoms had similar indications of malabsorption and similar body mass idices.

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Loss of bone density was more common in those with silent celiac disease than in those with latent celiac disease. Patients with silent celiac disease more regularly showed elevated levels of celiac-positive antibodies. As far as clinical symptoms of celiac disease, such as blood and antibody tests, the two groups showed no major differences.

The researchers concluded that even with no symptoms, most people diagnosed with celiac disease as children go on to develop active celiac disease as adults. Such patients should undergo screening for villous atrophy, and osteopenia, and should be encouraged to resume their gluten-free diet in the event that villous atrophy is detected.

Colleagues at Finland’s University of Tampere go so far as to say that even patients with latent celiac disease should follow a strict gluten-free diet. They feel that villous atrophy is only a small part of the equation, and a sign of well-advanced celiac, and that the use of mucosal damage as a standard for diagnosing celiac disease is incomplete and can lead to missed diagnosis and otherwise preventable damage.

Gut 2007; 56: 1379-1386, 1339-1340

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13 Responses:

 
an unknown user
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said this on
11 Nov 2007 5:03:00 AM PDT
Having a granddaughter diagnosed as a 3 year old, now 23, and doing extremely well, I am pleased that so much is being done in this area. Being on a gluten-free diet since 3, has not inhibited her from any activities in life, including rock climbing, etc.

 
Barbara Coots
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said this on
11 Nov 2007 3:29:52 PM PDT
I am 57 and onset of symptoms at 52. There are several friends diagnosed after 50. Thanks for the news. Barbara

 
Kay
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said this on
12 Nov 2007 6:10:50 AM PDT
A very concise explanation of the differences between latent and silent celiac disease, and why they both must adhere to the gluten-free diet.

 
Gerald Jones
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said this on
13 Nov 2007 10:27:26 AM PDT
Much better than a couple of previous articles I read. I am 65 and did not display celiac symptoms until I was 63.

 
Carrie Gervais
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said this on
13 Nov 2007 5:29:35 PM PDT
As a person with so-called 'silent celiac disease', diagnosed at age 40 after my son's diagnosis, readers need to keep in mind that what seems to be 'silent' may be quite pronounced, in comparison to how one can feel when on the gluten free diet. Clear thinking, much higher energy level, and less anxiety are just a few of the gluten free diet's benefits awaiting those with 'silent celiac disease'.

 
Sue Petit
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said this on
14 Nov 2007 10:41:40 AM PDT
Excellent article. Though not diagnosed until age 47, but I am pretty sure it was a problem all of my life. Didn't get diagnosed until chronic symptoms. Major wasting due to no absorption of nutrients.

 
David Lapham
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said this on
16 Nov 2007 9:57:44 PM PDT
I am 61 and have had dermatitis herpetaformis for over 22 years, but was never told anything about celiac disease. I tried a gluten-free diet in the middle 80s' but had to little information to go on. I have had problems since age 6 months that have significantly improved or totally cleared up since I have been gluten-free. To name a few, Upper respiratory infections 100s of times, digestive problems including stomach surgery (Atrophied duodenum and ulcers disease) anxiety, swelling on legs and ankles, dermatitis herpetaformis, peripheral neuropathy, pernicious anemia, and several others.
So I agree with a previous post that said that after beginning a gluten-free diet one may find a lot of things are better. For me, feeling so much better is what makes it worth all the expense and hard ship involved with the diet. I almost died before I found out what it was. Thanks to the Harvard Medical School's, Beth Israel Hospital, School of Dermatology's web site, I found that dermatitis herpetaformis is a positive diagnosis for celiac disease.
Thanks for a good article,
David Lapham Sr

 
Kathleen Eickwort
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said this on
23 Nov 2007 6:49:05 PM PDT
I have a brother who was diagnosed with celiac as a child and tends to eat now a diet very high in meat and potatoes...little bread, but certainly not gluten-free. He had ITP, though. It could be related.

 
Evelyn Schindler
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said this on
02 Dec 2007 8:15:31 AM PDT
Diagnosed for 2 years but had celiac problems for so long am still not healed...information is good...has been a big help to me.
Thanks

 
Patrick Armstead
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said this on
12 Dec 2007 2:37:09 PM PDT
I have been diagnosed for about 3.5 years now, but I'm sure that I had it well over 30 years before then. By chance I was just talking with a doctor at work after eating a healthy serving of waffles--one of my favorite meals. He made a bet with me that I had celiac--I said no, it was from my stomach surgery 35 years before. He ran some tests Glanin IGG normal was <11 High was 27-30, mine was 97mg/dl. I have been on the diet since June 2005 and with in a few weeks felt so much better, I wouldn't want to go back. But it is hard to go out with friends and family to eat.

 
Bonnell Penne
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said this on
21 Feb 2008 11:03:19 AM PDT
I was diagnosed with Celiac Sprue 30 years ago at the age of 13 months by biopsy and they said it was a classic case. In March of 2007, 29 years later at the age of 30, after a negative biopsy blood tests were done to confirm and they were negative as well for Celiac Sprue. I questioned the Gastroenterologist as to what is was 30 years prior and I didn't receive any answers. To this day I still have to question if the tests 30 years ago were wrong or not. I have introduce regular foods into my diet and haven't noticed that I feel any different. I include whole grain foods into my diet 1-2 times a day and have been doing fine. After reading this article I hope that the tests so long ago really were wrong as I do not want to be hurting my body and not know it. Could test results come back negative for Celiac when it really is 'Silent or Laten' celiac.

 
patricia
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said this on
10 Oct 2008 8:14:00 PM PDT
Thank you for the info. Many people think that I am lying when I discuss these issues of more than the typical 'fat-bellied malnourished child with chronic diarrhea'...

 
Aaron
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said this on
30 Oct 2008 1:00:11 PM PDT
But in this article, it is said, that adults were reintroducing a normal diet, that is, with a lot of wheat. But, what´s happened with the little quantity every day?




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Thanks all. I took you advice and I just went for a walk instead of doing intense cardio. I'm feeling quite a bit better today but since it's friday I'm gonna rest it up also

I've posted about this before, but I'm about 14 weeks in and have seen very little improvement. Did any of you take a long time to feel better, and do you think I should cast my doubts aside?

Here is a link to a good explanation below. Some people go a bit overboard with the " what ifs". Even , on the rare occasion the stuff is made from wheat oil, and it has a stray molecule of protein.... then it is .05% ( maybe less?) of a whole 4 oz bottle of lotion- even if you drank the whole bottle- it isn't enough to gluten you. http://www.glutenfreedietitian.com/vitamin-e-from-wheat-germ-oil/ the author of of this article is well respected in the Celiac medical/ research community and has spoken at International Celiac Research symposiums

http://www.gluten-free-glutenfree.com/nepal-traveling-as-a-celiac