Grown-up coeliac children: the effects of only a few years on a gluten-free diet in childhood.
OBJECTIVE
To evaluate clinical and psychological status of adults with childhood diagnosis of coeliac disease who were re-exposed to gluten after only a few years and now on a gluten-containing diet, compared with adults with recent diagnosis of coeliac disease, and adults who remained on gluten-free diet after childhood diagnosis.


METHODS
A total of 195 adults with a biopsy suggestive of coeliac disease in childhood, who either had adhered to a gluten-free diet for at least 1 year after diagnosis and now are either on gluten-free diet (n = 110) or on gluten-containing diet (n = 85), and adults with newly diagnosed coeliac disease (n = 165) underwent a medical check-up.


RESULTS
Body mass index and main laboratory indices were statistically different among groups (lowest in never on gluten-free diet, highest in gluten-free diet). The lowest average levels of bone mineral density were found among never on gluten-free diet patients. Prevalence of autoimmune disorders was increased in never on gluten-free diet when compared with the transient gluten-free diet and gluten-free diet groups. Histology revealed villous subatrophy in all patients of never on gluten-free diet group, in 39 of 110 patients of gluten-free diet and in 84 of 85 of transient gluten-free diet groups. Herpetiform dermatitis was found in three patients of gluten-free diet, three of transient gluten-free diet and three of never on gluten-free diet. Dental enamel defects were found in 15 patients of transient gluten-free diet, 43 of never on gluten-free diet and in zero of the gluten-free diet group. Pregnancy outcome was not significantly different between the two groups, but neonatal weight was lower and breast feeding was shorter in the never on gluten-free diet group. Sexual habits, alcohol intake and cigarette smoking were significantly different in the never on gluten-free diet group when compared with the other two groups.


CONCLUSIONS
Gluten withdrawal in childhood partly protects coeliac adults from clinical and behavioural effects of gluten sensitivity.
Ciacci
C
C
Gastrointestinal Unit, Federico II University of Napoli, Naples, Italy. ciacci@unina.it
Iovino
P
P
Amoruso
D
D
Siniscalchi
M
M
Tortora
R
R
Di Gilio
A
A
Fusco
M
M
Mazzacca
G
G
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D000886:Anthropometry; D001284:Atrophy; D015992:Body Mass Index; D015519:Bone Density; D002446:Celiac Disease / Q000178:diet therapy* / Q000473:pathology / Q000523:psychology; D005260:Female; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012725:Sexual Behavior; D012907:Smoking
D005983:Glutens