Definitive diagnosis of coeliac disease involves biopsy of the small intestine, showing tissue damage. People with a positive blood test for the condition but no positive biopsy usually are diagnosed as "potential" celiac patients and may or may not be advised to follow a gluten-free diet.
However, in a recdent study Ivano Bertini and colleagues used magnetic resonance metabolic profiling to analyze the biochemical markers in the blood and urine of 61 patients with celiac disease, 29 with potential celiac disease, and 51 healthy people. They found that those with potential disease largely shared the same profile as those with the confirmed disease and that the biochemical markers in both groups differed significantly from those of the healthy individuals.
They suggest that their results show that metabolic alterations may precede the development of small intestinal villous atrophy and that the early institution of gluten-free diet in patients with potential celiac disease woudl be advisable.
Are Patients with Potential Celiac Disease Really Potential? The Answer of Metabonomics. Journal of Proteome Research, 2010
More research on the management of coeliac disease
