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Spelling
- Celiac is the canonical spelling used throughout this knowledge base.
- Coeliac is a Commonwealth spelling but should not be used in authored prose.
Synonyms (historical / informal)
- Celiac sprue
- Nontropical sprue
- Endemic sprue
- Gluten enteropathy
- Gluten intolerance and gluten sensitivity — nonspecific; lack consistent definitions; discouraged as synonyms
Related (but distinct) Gluten-Related Disorders
- Gluten ataxia — neurological autoimmune disorder triggered by gluten
- Wheat allergy — IgE-mediated allergic reaction (different mechanism from celiac)
- Dermatitis herpetiformis — skin manifestation of gluten sensitivity
- Non-celiac gluten sensitivity (NCGS) — functional disorder; symptoms resolve on GFD but without autoimmune markers
Presentation Subtypes
| Subtype | Description |
|---|---|
| Asymptomatic / Silent | No symptoms; often found via screening. Asymptomatic = silent (both valid terms) |
| Subclinical | Signs only detectable via labs/endoscopy; no patient-perceived symptoms |
| Classical (overt) | Malabsorption, diarrhea, weight loss, failure to thrive — typically children |
| Non-classical (atypical) | Extraintestinal symptoms predominate; no typical malabsorption — more common in adults |
| Symptomatic | Any presentation with symptoms related to gluten, classical or non-classical |
| Potential celiac disease | Positive serology + positive HLA genetics, but no villous atrophy on biopsy |
| Refractory celiac disease (RCD) | Persistent malabsorption + villous atrophy after ≥12 months on GFD |
Non-Responsive Celiac Disease (NRCD)
Persistent symptoms despite excluding gluten for 6–12 months. Most NRCD is not RCD — other causes (SIBO, giardiasis, FODMAP intolerance, etc.) are usually responsible.
Refractory Celiac Disease (RCD) — Two Types
- Type 1: Histopathological changes similar to untreated celiac; treated with steroids, azathioprine, budesonide
- Type 2: Abnormal intraepithelial lymphocytes; higher mortality; risk of enteropathy-associated T-cell lymphoma (EATL); treated with cladribine, cyclosporine, stem cell transplants
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