What Is Latent Celiac Disease?

Many associate celiac disease with gastrointestinal symptoms. But what happens when patients don't develop symptoms or other complications? Today we'll show you what latent celiac disease is and how it differs from other manifestations of the disorder.
What Is Latent Celiac Disease?

Written by Josberth Johan Benitez Colmenares, 27 June, 2021

Last update: 27 June, 2021

Latent celiac disease is one of the many manifestations of celiac disease. Although its incidence has been reported for several decades, we still have very little understanding about this autoimmune disorder. Today, we’ll show you everything we know about it, including the diagnostic process and the treatments indicated by the specialists.

Characteristics of latent celiac disease

Latent celiac disease is rare
Although the incidence of latent celiac disease is low, its diagnosis is actually difficult due to the absence of symptoms.

Latent celiac disease is diagnosed in patients who carry the genes for the disorder but haven’t yet developed symptoms. They’re on a gluten-based diet and the endoscopic biopsy shows no atrophy in their intestinal villi.

Its differences with respect to silent or asymptomatic celiac disease is that, in these cases, those diagnosed do develop atrophy in their villi. However, those with the latent variant haven’t yet developed symptoms, although they will occur at some point in the course of the disease.

It generally has a low prevalence in the general population. Researchers point out that this variant forces us to reconsider everything that we know about the disease.

The reason for this is that, as far as we know, intestinal villus biopsy is the only 100% safe method to detect it. Finding out that this isn’t the case, therefore, forces specialists to modify their understanding of it.

Although patients don’t show any symptoms when eating gluten, mild signs can still develop. For example, evidence suggests that up to 67% may be anemic and about 40% have vague symptoms intermittently.

They may develop sporadic episodes of constipation or diarrhea, in such a way that a gastrointestinal problem isn’t suspected. They can also develop low bone mineral density.

Complications of latent celiac disease

Let’s briefly recall what latent celiac disease is. It’s an absence of symptoms and damage to the villi, but with positive serological tests for the disease. Since patients eat a gluten-based diet, and their bodies are prone to complications, the chances of some conditions are higher than in people without the genes.

For example, research published in Fertility and Sterility in 2011 suggests that this variant may pose a risk to women’s reproductive health. Evidence and studies also indicate that you may also develop epilepsy and Crohn’s disease.

The problem with this variant is that it’s impossible to know when it’ll go from latent to active behavior. Neither do we know if the condition of the villi will remain stable, or if there’s a likelihood that complications will develop in the future. For this reason, experts consider it to be one of the most dangerous forms of celiac disease.

Diagnosis of latent celiac disease

As studies have shown, a biopsy is useless when diagnosing the disorder. The only way to do this is through serological tests, which measure specific antibodies against certain substances within the body.

The Celiac Disease Foundation reminds us that the main method used is the tTG-IgA test. In turn, endomysial antibody IgA, total serum IgA, deamysed gliadin peptide, and intestinal fatty acid-binding protein can be tested.

Due to the absence of complications, latent celiac disease often goes unnoticed and undiagnosed. The following risk groups should be tested to rule it out:

  • People who went through various intestinal problems during childhood.
  • People with Down syndrome.
  • Those with a family history of celiac disease or gastrointestinal conditions.
  • Those with other autoimmune disorders, such as rheumatoid arthritis, lupus, and so on.

The first case is of special interest. Celiac disease often manifests itself during childhood, but then passes into a latent state that can last for decades or be permanent. If, during your childhood, you suffered from complications such as diarrhea, constipation, abdominal pain or flatulence on a recurring basis, you should take serological tests.

Treatment for latent celiac disease: gluten-free diet?

Gluten-free diet.
How the condition develops, the results of the complementary studies, and the medical opinion all influence the final decision to abstain from consuming gluten.

We have finally reached the crucial point: the treatment. Despite the absence of symptoms and the fact that the related complications are less serious than in other types (for example, refractory and even classic celiac disease), patients are advised to permanently eliminate gluten from their diet.

This, of course, can represent an adherence challenge. After all, this protein is present in hundreds of food products. However, you must take into account the benefits of doing so, especially if it isn’t certain whether the disorder will be latent for years or will evolve into a symptomatic state unexpectedly.

If you think that eliminating gluten completely will be a very drastic change for you, then you can try reducing it. Halve the amounts of bread, oatmeal, biscuits, cookies, pasta and other gluten-containing goods that you eat. At the same time, carry out a general examination of your health in search of deficiencies or hidden problems related to the disease.

If everything is in order, then you can maintain a diet that includes gluten, as long as it’s reduced. You should also have an annual appointment with the specialist to keep the disease under control. If you don’t want to take any risks, then consult a nutritionist to devise a plan that eliminates gluten from your diet and complements it with a balanced diet.

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