Omitting control biopsy in paediatric coeliac disease: a follow-up study.
OBJECTIVE
To evaluate the practice of diagnosing coeliac disease with only one small-bowel mucosal biopsy in a selected group of children with suspected coeliac disease.


METHODS
A retrospective review of medical records and a follow-up interview of 102 children (65 girls, 37 boys) at diagnosis of coeliac disease. The inclusion criteria were age >18 months, increased levels of serum antitissue transglutaminase IgA antibodies and pathologic small-bowel mucosal biopsy. Anthropometric data were calculated for children 1.5-11 years of age.


RESULTS
The levels of serum antitissue transglutaminase IgA antibodies were either normal (92%) or slightly elevated (8%) in all children after 1 year on a gluten-free diet. The height-for-age Z score increased in 52 of 61 (85%) children, (median 0.26 SD, range -0.45 to 1.83 SD) and the weight-for-age Z score increased in 50 of 61 (82%) children (median 0.42 SD, range -0.77 to 2.24 SD). Sixty of 61 (98%) children showed normal or catch-up growth. Regression of symptoms after 1 year on a gluten-free diet was reported for 71 of 72 (98%) children.


CONCLUSIONS
We propose that a control biopsy is not necessary for the diagnosis of coeliac disease in these children.
Killander
Anna
A
Department of Women and Child Health, Karolinska Institutet, Stockholm Sweden. anna.killander@karolinska.se
Arnell
Henrik
H
Hagenäs
Lars
L
Finkel
Yigael
Y
D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy / Q000276:immunology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology*
D007070:Immunoglobulin A; D011503:Transglutaminases