title: Prevalence and natural history of potential celiac disease in adult patients.
abstract: OBJECTIVE
  Potential celiac disease (PCD) is a form of CD characterized by positive endomysial/tissue transglutaminase antibodies and a preserved duodenal mucosa despite a gluten-containing diet (GCD); it can evolve into flat, active CD. This evolution is, however, not certain. Our aim was to retrospectively study the prevalence and the natural history of adult patients with PCD.
  
  
  METHODS
  The clinical notes of all 47 patients with PCD attending our clinic between September 1999 and October 2011 were retrospectively reevaluated. To study their clinical features, patients with active CD, randomly selected and matched for sex and date of birth, served as controls. Symptoms, associated diseases, familiarity, and laboratory data at diagnosis were compared.
  
  
  RESULTS
  Prevalence of PCD among all celiac patients directly diagnosed in our center was 42/187, (1/4.4, 18.3%, 95% confidence interval (CI) 13.3-23.4%). Age at diagnosis, laboratory data, prevalence of symptoms, associated diseases, and familiarity for CD did not differ between patients with PCD and those with active CD. Some patients with PCD maintained a normal duodenal mucosa for many years and their symptoms spontaneously improved despite maintaining a GCD.
  
  
  CONCLUSIONS
  PCD is not a rare form of CD. Having found no difference at all in age at diagnosis and clinical features between PCD and active CD could suggest that PCD is not a prodrome of CD but is a separate entity that can only subsequently evolve into active CD.
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. f.biagi@smatteo.pv.it
authors.forename: Federico
authors.initials: F
authors.lastname: Biagi
authors.forename: Lucia
authors.initials: L
authors.lastname: Trotta
authors.forename: Claudia
authors.initials: C
authors.lastname: Alfano
authors.forename: Davide
authors.initials: D
authors.lastname: Balduzzi
authors.forename: Vincenza
authors.initials: V
authors.lastname: Staffieri
authors.forename: Paola I
authors.initials: PI
authors.lastname: Bianchi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marchese
authors.forename: Claudia
authors.initials: C
authors.lastname: Vattiato
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zilli
authors.forename: Ombretta
authors.initials: O
authors.lastname: Luinetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Gobbi
authors.forename: Gino R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology* / Q000473:pathology; D055050:Diet, Gluten-Free; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult