Potential celiac disease

Potential celiac disease (PCD) is a clinical condition characterized by the presence of a positive celiac disease (CD) serology, a predisposing HLA haplotype and a normal intestinal architecture. From an immunological point of view, PCD patients have already mounted a gluten-specific T cell mediated response, but their intraepithelial lymphocytes (IELs) are not “licensed to kill” intestinal epithelial cells and tissue damage does not occur. Patients may present or not clinical symptoms and may evolve or not to an overt form of CD later in time. Levels of antitissue transglutaminase are generally present at a lower title compared to classical CD and may fluctuate or even disappear during follow-up. Different risk factors have been associated to patient’s outcome, but UpToDate, clinical management and dietary indications in this condition remain a challenging issue for the clinician.