engleski

The rate of relapse after gluten challenge in patients with celiac disease - is there any age difference?

It is suggested that celiac disease (CD) in children younger than two years should be diagnosed following the "old" ESPGHAN criteria, while in older children, the revised criteria (one small intestinal biopsy and good clinical response to gluten-free diet) are sufficient. The aim was to determine the effect of age at time of initial biopsy on the proportion of patients whose diagnosis of CD was not confirmed by third biopsy. Patients and methods: At least three small intestinal biopsies were used ti diagnose CD in 62 patients irrespective of age. According to age at the time of first biopsy, patients were divided into: group A (n=49, younger than 24 months) and group B (n=13, older than 24 months). Student's t-test was used for statistical analysis. Results: After 6 months of gluten challenge, 13 group A patients (26.5%) had normal small intestinal biopsy. Seven (14%) patients experienced no relapse after more than 2 years of gluten-containing diet. In group B, 5 (38.5%) patients had normal biopsy after 6 months of gluten challenge. Three (23%) patients have been on gluten-containing diet for more than 2 years, still without histologic relapse. Although the proportion of patients without relapse was higher in group B, the difference was not significant after 6 or 24 months of gluten challenge (p more than 0.05 both). Conclusion. A high proportion of patients irrespective of age had no histologic relapse after more than two years of gluten-containing diet. These results show that different diagnostic criteria for patients younger and older than two years may be implausible.

celiac disease; children gluten challenge

nije evidentirano