WHAT-IS-cdaForgive my ignorance, but I had a stumper while reading a recent research article.  I discussed the research in my article Shedding light on which children may have a greater chance of celiac It was about how certain genes and the number of them could increase the chance that a child would get celiac disease autoimmunity or celiac disease.

I had the worst time getting past the term celiac disease autoimmunity (CDA).  My daughter has had celiac for 14 years and I have been writing about it for nearly 6 years and I swear I have never heard of CDA. Was I not paying attention??

So when I asked one of the authors of the research some questions about the study, I had to inquire about CDA.  So in case you had the same question, here are your answers.

What is Celiac Disease Autoimmunity?

The term celiac disease autoimmunity was actually coined in the Oslo Definitions of Celiac Disease by high-level researchers.  They were published in January 2013. This document defines CDA as when a patient has positive TtG or EMA blood test, but no biopsy. 

“We defined coeliac disease autoimmunity as positive TTG or EMA on at least two occasions.  In a clinical setting this will lead to a small intestinal biopsy, and patients can then be classified as either CD (positive biopsy) or potential CD (negative biopsy), but in a research setting there are circumstances where small intestinal biopsy has not been performed. The term coeliac [celiac] disease autoimmunity should then be used.” — Oslo Definitions of Celiac Disease 2013

Edwin Liu, M.D., pediatric gastroenterologist from the CU School of Medicine and Children’s Hospital Colorado explained to The Savvy Celiac, “I hope someday it will replace the term currently used, which is ‘potential celiac’.”  

“[CDA] tells us that the autoimmune process has started, or at least something is going on,” Dr. Liu said. A patient’s antibodies may be elevated but maybe they aren’t showing symptoms yet or a biopsy didn’t show any damage…this would be considered celiac disease autoimmunity.    “So yes, it could be seen an a way as a precursor to celiac, or indication of celiac disease already being present.”

So my layman’s take is that it is the early sign of celiac.  The NIH article about the recent research said people with CDA should also be on the gluten-free diet.

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One Response to “What is Celiac Disease Autoimmunity?”

  1. Thank you! This has been driving me crazy! It could very well be a child with CD where the parent has decided against biopsy. A friend of mine did that with her kids. She has the disease and her kids have the genes. As soon as their blood work showed antibodies, she just put them on a GF diet. I see why they differentiate though – since its not proven. However, its likely not just a precursor but the full blown disease I think. My son has 2 copies of the gene and wasn’t diagnosed until age 13. I constantly look back and wonder how long he has had it undiagnosed….

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