engleski

The rate of relapse after the gluten challenge in patients suspected to have coeliac disease (CD): Is there any age difference?

It is suggested that CD in children younger than two years should be diagnosed following the “old” ESPGAN criteria, while in older, revised criteria (one small intestinal biopsy and good clinical response on gluten-free diet) is sufficient. The aim was to determine the effect of age at time of initial biopsy on proportion of patients whose diagnosis of CD was not confirmed by the third biopsy. Patients and methods. At least three small intestinal biopsies were used to diagnose CD in 62 patients irrespective of their age. According to the age at time of the first biopsy, patients were divided in: group A (N=49, younger than 24 months) and group B (N=13, older than 24 months). Student T-test was used for statistics. Results. After 6 months of gluten challenge, 13 patients in group A (26.5%) had normal small intestinal biopsy. Seven patients (14%) after >2 years on gluten-containing diet still did not relapse. In group B, 5 patients (38.5%) had normal biopsy after 6 months of gluten challenge. Three patients (23%) are on gluten-containing diet >2 years, still without histological relapse. Although proportion of patients who did not relapse was higher in group B, the difference was not significant after 6 (p>0.05) nor after 24 months of gluten challenge (p>0.05). Conclusion. High proportion of patients, irrespective of their age, did not have histological relapse after more than two years of gluten-containing diet. Results show that different diagnostic criteria for patients younger and older than two years may be implausible.

celijakija; djeca; dijagnostički kriterij

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