Latent coeliac disease in Italy

The term latent coeliac disease applies to patients who have a normal jejunal biopsy while taking a normal diet and, at some other time, before or since, have had a flat jejunal biopsy recovering on a gluten-free diet. Nineteen such patients were identified after a multicentre search conducted under the auspices of the Italian Society for Paediatric Gastroenterology and Hepatology (SIGEP). Serological data and histological material suitable for morphometric analysis were available from 10 and 8 patients, respectively, while they were on a gluten-containing diet. Neither gliadin antibodies nor increased density of intraepithelial lymphocytes are obligate markers of latent coeliac disease; endomysial antibodies are likely to be best predictors of evolution towards villous atrophy. Prospective studies are needed to allow a more precise definition of latent coeliac patient features.