title: Clinical, serologic, and histologic features of gluten sensitivity in children.
abstract: OBJECTIVE
  To describe the clinical, serologic, and histologic characteristics of children with gluten sensitivity (GS).
  
  
  METHODS
  We studied 15 children (10 males and 5 females; mean age, 9.6 ± 3.9 years) with GS who were diagnosed based on a clear-cut relationship between wheat consumption and development of symptoms, after excluding celiac disease (CD) and wheat allergy, along with 15 children with active CD (5 males and 10 females; mean age, 9.1 ± 3.1 years) and 15 controls with a functional gastrointestinal disorder (6 males and 9 females; mean age, 8.6 ± 2.7 years). All children underwent CD panel testing (native antigliadin antibodies IgG and IgA, anti-tissue transglutaminase antibody IgA and IgG, and anti-endomysial antibody IgA), hematologic assessment (hemoglobin, iron, ferritin, aspartate aminotransferase, erythrocyte sedimentation rate), HLA typing, and small intestinal biopsy (on a voluntary basis in the children with GS).
  
  
  RESULTS
  Abdominal pain was the most prevalent symptom in the children with GS (80%), followed by chronic diarrhea in (73%), tiredness (33%), bloating (26%), limb pain, vomiting, constipation, headache (20%), and failure to thrive (13%). Native antigliadin antibodies IgG was positive in 66% of the children with GS. No differences in nutritional, biochemical, or inflammatory markers were found between the children with GS and controls. HLA-DQ2 was found in 7 children with GS. Histology revealed normal to mildly inflamed mucosa (Marsh stage 0-1) in the children with GS.
  
  
  CONCLUSIONS
  Our findings support the existence of GS in children across all ages with clinical, serologic, genetic, and histologic features similar to those of adults.
authors.affiliation: Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy. Electronic address: rfrancavilla@gmail.com.
authors.forename: Ruggiero
authors.initials: R
authors.lastname: Francavilla
authors.affiliation: Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Cristofori
authors.affiliation: Department of Pediatrics, San Paolo Hospital, Bari, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Castellaneta
authors.affiliation: Department of Pediatrics, Rovereto Hospital, Rovereto, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Polloni
authors.affiliation: Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Albano
authors.affiliation: Tandoi Group, Corato, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Dellatte
authors.affiliation: Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Indrio
authors.affiliation: Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Cavallo
authors.affiliation: Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catassi
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000906:Antibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004848:Epithelium / Q000276:immunology; D005183:Failure to Thrive / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood* / Q000175:diagnosis*; D005903:Gliadin / Q000276:immunology; D005983:Glutens / Q000276:immunology*; D006683:HLA-DQ Antigens / Q000097:blood; D006261:Headache / Q000209:etiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D014839:Vomiting / Q000209:etiology
chemical_list: D000906:Antibodies; D015415:Biomarkers; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D007074:Immunoglobulin G; D005983:Glutens; D005903:Gliadin