The Complexity of Celiac Disease

Children who have positive celiac antibodies and normal small-bowel mucosal villous morphology benefit from a gluten-free diet.

Positive celiac antibodies and small-bowel mucosal villous atrophy are diagnostic criteria for classic celiac disease. But do antibody-positive children with normal villous structure also benefit from a gluten-free diet? To find out, investigators in Finland followed children who were referred because of suspicion of celiac disease (symptoms included abdominal pain, diarrhea, and poor growth); 13 were endomysial antibody (EMA) positive with normal biopsy, and 30 were EMA positive with villous atrophy.

Among the 13 EMA-positive children with normal villous morphology, 5 immediately started a gluten-free diet; their clinical symptoms resolved, and antibody values normalized after 1 year on a gluten-free diet. The other eight children continued…

Reviewing Author

Howard Bauchner, MD

Disclosures

Grant / research supportHuman Resources and Services Administration; NIH; NIH-NHLBI; USDA; GlaxoSmithKline

Editorial boardsArchives of Disease in Childhood (Editor-in-Chief)

Howard Bauchner, MD

Disclosures

Grant / research supportHuman Resources and Services Administration; NIH; NIH-NHLBI; USDA; GlaxoSmithKline

Editorial boardsArchives of Disease in Childhood (Editor-in-Chief)