What Are Celiac Disease Subtypes And Why Should I Learn About Them?

The identification of celiac disease subtypes is crucial for both healthcare practitioners and patients to facilitate precise diagnosis, customize treatment plans, and execute effective management protocols. These subtypes represent the varied manifestations of celiac disease in individuals, encompassing traditional gastrointestinal symptoms, as well as silent and atypical cases.

Celiac Disease Subtypes

Celiac disease subtypes are defined using the ”four out of five rule” which indicates that four out of five of the following criteria are enough to establish a celiac disease diagnosis.

Reference: Catassi C, Fasano A. Celiac disease diagnosis: simple rules are better than complicated algorithms. Am J Med 2010;123:691-3.

Typical and/or atypical signs and symptoms (diarrhea and malabsorption)
Antibody positivity
Positive biopsy showing intestinal damage
HLA-DQ2 and/or HLA-DQ8 genetics positivity
Positive response to gluten-free diet (GFD)

CD Subtype	Symptoms	Antibodies	Biopsy	Genetics	GFD Response
Classic	POSITIVE	POSITIVE	POSITIVE	POSITIVE	POSITIVE
Seronegative	POSITIVE	NEGATIVE	POSITIVE	POSITIVE	POSITIVE
Potential	POSITIVE	POSITIVE	NEGATIVE	POSITIVE	POSITIVE
Silent	NEG/POS	NEG/POS	NEG/POS	POSITIVE	POSITIVE
Negative	NEG/POS	NEG/POS	NEG/POS	NEGATIVE	NEG/POS

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