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

Abstract

There is limited data on the clinical consequences of potential coeliac disease (PCD). To compare the presentation of PCD with coeliac disease (CD). A retrospective study of adult PCD patients (>18 years) was performed. Presenting manifestations, serology and HLA-DQ genotyping were compared to an age-at-diagnosis and sex-matched CD cohort. 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. 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.