Archives of Disease in Childhood, Vol 70, 211-213, Copyright © 1994 by Archives of Disease in Childhood.
Need for follow up in coeliac disease
MT Bardella, N Molteni, L Prampolini, AM Giunta, AR Baldassarri, D Morganti and PA Bianchi
Department of Gastroenterology, Istituto di Scienze Mediche, Milan, Italy.
The use of follow up studies was evaluated in 128 patients with coeliac
disease during their first visit to a department for adults. The original
diagnosis had been made in childhood in all patients. Fifty eight (45%) of
the subjects were following a gluten free diet, 23 (18%) were following a
gluten free diet but with occasional gluten consumption, and 47 (37%) had
adopted an unrestricted, gluten containing diet for a mean of 11.2 years.
There was no correlation in individual subjects between the presence of
symptoms, biochemical and immunological abnormalities, severity of
histological findings, and the amount of dietary gluten, despite the
greater frequency of symptoms in the group following an unrestricted diet
than in the other two groups. Short stature and epilepsy with cerebral
calcifications only occurred in patients following an unrestricted diet. As
only diagnosis based on two or three biopsy samples and regular follow up
correlated positively with dietary compliance, it is suggested that a
histologically confirmed diagnosis of coeliac disease and regular lifelong
follow up are essential in the management of these patients.
