Clinical, biochemical and histological abnormalities in adult celiac patients on gluten-free diet.
Twenty-six adult patients with histologically confirmed celiac disease on gluten-free diet after apparent disease remission were reexamined at 4-6 months intervals for a mean period of 55.4 months (range 13-137). Eight patients remained clinically well with normal blood tests. Eighteen patients had clinical or biological abnormalities. Eleven patients reported repeated episodes of meteorism and abdominal pain and/or diarrhea which disappeared in 2 after lactose withdrawal. Iron deficiency and macrocytic anemia were sometimes observed in 5 and 4 patients respectively. Altered plasma calcium, phosphorus and alkaline phosphatase and/or bone densitometry findings were detected in 7 patients. Seventeen patients (12 presenting some of the above findings) agreed to a repeat biopsy: 13 of these showed grade II and 4 grade III abnormalities. Although adult celiac patients may show marked improvement during gluten-free diet, minor clinical disturbances and biochemical abnormalities may still be present.
D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000178:diet therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000473:pathology; D008297:Male; D008875:Middle Aged