Very late mucosal relapse in a girl with coeliac disease.
Small bowel biopsy in a 4-year-old girl with symptoms suggestive of coeliac disease revealed subtotal villous atrophy. The mucosa healed on a gluten-free diet. From the age of 7 years, the girl was challenged with gluten. Annual biopsies showed normal or nearly normal mucosa specimens. At 21 years of age, after 14 years of gluten challenge, a mucosal relapse was found and a gluten-free diet was reinstituted. A biopsy one year later showed a normal mucosa. From this case report it is apparent that a patient with a past history of subtotal villous atrophy, which after a preceding period of gluten-free diet does not recur within two years of gluten challenge, must be followed carefully, so as not to miss a late relapse.
Högberg
L
L
Department of Paediatrics, Norrköping Hospital, Sweden.
Stenhammar
L
L
Wågermark
J
J
D000328:Adult; D002446:Celiac Disease / Q000178:diet therapy / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005983:Glutens; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D012008:Recurrence; D013997:Time Factors
D005983:Glutens