Is gluten challenge necessary for the diagnosis of coeliac disease in young children?
Sixty-seven children under 2 years of age presenting with a classic clinical picture of coeliac disease with a severe small-intestinal mucosal lesion were investigated. All improved clinically and histologically on a gluten-free diet. During gluten challenge the mucosal damage recurred in 64 (95.5%) children, thus fulfilling the criteria for coeliac disease formulated by the European Society for Paediatric Gastroenterology and Nutrition. Three (4.5%) children had no mucosal relapse 2 years or more after return to a gluten-containing diet. These children were classified as having transient gluten intolerance. The low frequency of non-relapsers in the present study calls into question the practice of performing gluten challenge.
Danielsson
L
L
Dept. of Paediatrics, Central Hospital, Danderyd, Sweden.
Stenhammar
L
L
Aström
E
E
D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005983:Glutens; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008297:Male
D005983:Glutens