5 Types of Celiac Disease

[aklap]

I have this scattered through-out this place. I just wanted to have it's own post so I don't have to look for it all the time

Celiac disease is currently classified into four subphenotypes:


Classical celiac disease - manifests with classical GI symptoms of diarrhea and weight loss from malabsorption. Both serological and biopsy results confirm the diagnosis, and symptoms improve on a gluten free diet.

The most commonly described form. It describes patients with the classical features of intestinal malabsorption who have fully developed gluten-induced villous atrophy and the other classic histological features. These patients present because of GI symptoms, and are identified as CD sufferers through the investigation of these symptoms. This group can also be said to have symptomatic CD.


Celiac disease with atypical symptoms - features a predominance of extraintestinal manifestations with few or no GI symptoms. As with classical celiac disease, diagnosis is made with positive serology and biopsy samples and amelioration from a gluten free diet.

Appears to be one of the most common forms. These patients generally have little to no GI symptoms, but seek medical attention because of another reason such as iron deficiency, osteoporosis, short stature, or infertility. These patients generally have fully developed gluten-induced villous atrophy. Because these patients are “asymptomatic” from the GI perspective, if their atypical CD feature is not recognized, they may be difficult or impossible to distinguish from “true” silent (asymptomatic) CD patients.


Silent celiac disease - is categorized by individuals being completely asymptomatic, but testing positive with serology and biopsy. Detection is usually from screening of high risk groups, or when biopsies and endoscopies are performed for other reasons.

A very common form of CD. Refers to patients who are asymptomatic but are discovered to have fully developed gluten-induced villous atrophy after having undergone serologic screening or perhaps an endoscopy and biopsy for another reason. These patients are clinically silent, in that they do not manifest any clear GI symptoms or associated atypical features of CD such as iron deficiency or osteoporosis. These patients can be confused with atypical CD if their atypical features are not recognized in an early stage. As well, Fasano et al.15 have shown that many of these patients do not manifest fully developed villous atrophy.


Latent celiac disease - is associated with positive serological tests, but negative biopsy results. While asymptomatic at the time of diagnosis, in the future symptoms usually develop and/or histological changes are evident upon repeat biopsy.

Represents patients with a previous diagnosis of CD that responded to a GFD and who retain a normal mucosal histology upon later re-introduction of gluten. Latent CD can also represent patients with currently normal intestinal mucosa who will subsequently develop gluten-sensitive enteropathy.


Refractory CD. For the purpose of this review, patients with refractory CD are patients with true CD and villous atrophy (i.e., not a misdiagnosis) who do not, or no longer, respond to a GFD. Although the most common reason for failure to respond to a GFD is dietary indiscretion or unknown exposure to gluten, refractory CD also occurs in patients on a GFD who have developed a complication such as ulcerative-jejunoileitis, or enteropathy-associated lymphoma. Patients with refractory CD do not necessarily have positive serology for CD. Refractory CD was reviewed in the context of the requested objectives.

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Symptomatic celiac disease is associated with considerable morbidity due to chronic gastrointestinal symptoms and malabsorption of nutrients, weight loss, metabolic bone disease, anemia and general debility. The significance of the disease in the majority of individuals with silent celiac disease is less clear. However, most patients with silent celiac disease have occult manifestations of the disease, including reduced bone density, iron or folate deficiency and associated autoimmune diseases that are frequently more clinically significant. Celiac disease results in an increased risk of the development of various malignancies including lymphoma at any site, not only the small intestine. There is also an increased mortality rate in celiac disease, exceeding that of the general population by a factor of 1.9 to 3.8. The increased mortality is mainly due to malignancies. The excess mortality is reduced after 1 to 5 years on a gluten free diet, demonstrating protection by the gluten-free diet.

note: 12/10/05 - updated list - found more detailed explainations.
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Al

“We cannot all do great things, but we can do small things with great love.” Mother Teresa

[Sara]

which one that makes you constipated?
I'm always constipated. Not sure if its from the celiac disease or something else

[aklap]

Hi Sara,

Well...any of the could cause constipation...odd as it seems. That's just the opposite of the classic symptoms, but it does happen.

It is possible it could be other things too. Have you seen a doctor about that? In my case...it's usually lack of fiber
_________________
Al

“We cannot all do great things, but we can do small things with great love.” Mother Teresa

[aklap]

bump
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Al

“We cannot all do great things, but we can do small things with great love.” Mother Teresa

[Padams]

Al,

I know you may not know the answer to this question .. but I'll give it a shot.

Does Refractory Sprue form from Celiac Disease? Or .. have I had Refractory Sprue this whole time?

It's a loaded question, I know ..

Sorry about that ..

Take care, Al!
-Patrick
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Patrick
06/14/05
I love Danna Korn

[aklap]

bump for AGK
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Al

“We cannot all do great things, but we can do small things with great love.” Mother Teresa

[aklap]

bump
_________________
Al

“We cannot all do great things, but we can do small things with great love.” Mother Teresa