Celiac disease (CD) is a chronic autoimmune enteropathy triggered by gluten ingestion in genetically predisposed individuals. While the classic presentation involves intestinal damage, a subset of children presents with positive celiac-specific antibodies, particularly against tissue transglutaminase (tTG), but have normal or near-normal duodenal villous architecture upon biopsy. This condition is often referred to as potential celiac disease (PCD). Understanding the natural history and factors influencing the progression from PCD to overt CD (characterized by mucosal atrophy) is crucial for clinical management. This article synthesizes findings from recent studies to explore the progression of CD in children with positive tTG antibodies and initially normal duodenal architecture. It examines factors associated with progression, potential biomarkers, and current diagnostic and management approaches for this specific pediatric population.

Celiac Disease, Tissue Transglutaminase Antibodies, Pediatric Gastroenterology

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