scholarly journals Effect of gluten-free diet on the growth and nutritional status of children with coeliac disease

2009 ◽  
Vol 137 (11-12) ◽  
pp. 632-637 ◽  
Author(s):  
Nedeljko Radlovic ◽  
Marija Mladenovic ◽  
Zoran Lekovic ◽  
Dragana Zivanovic ◽  
Radivoj Brdar ◽  
...  
Keyword(s):  
Growth Rate ◽  
Small Bowel ◽  
Nutritional Status ◽  
Coeliac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Small Bowel Mucosa ◽  
And Gender ◽  
Nutritional Status Of Children ◽  
Bowel Mucosa

Introduction. Gluten-free diet (GFD) presents the basis of coeliac disease (CD) treatment. If strictly applied, the disorders of the small bowel mucosa and other disease signs rapidly resolve. Objective. The goal of the study was to evaluate the effect of GFD on the growth and nutritional status of children with the classical form of CD. In addition, we analyzed the differences between these parameters with the duration and the patients' compliance with GFD. Methods. The study goals were achieved on a sample of 90 children, 56 female and 34 male, aged 0.5-7.5 (1.53?1.05) years, with the classic CD diagnosed on the basis of typical pathohistological findings of the small bowel mucosa and clinical recovery of patients on GFD. The duration of the patients' follow-up was 1.08-8.75 (3.03?1.14) years, i.e. until the age of 2.5-15 (4.59?1.78) years. The initial and control values of body height (BH) in relation to matched values for age and gender were expressed in percentiles, while the deviation in body weight (BW) for the matched values of height and gender was expressed in percentages. The referent haemoglobin (Hb) rate in blood, as a laboratory indicator of nutritional status in children aged up to 5 years was ?110 g/L, and for those aged above 5 years it was ?115 g/L. Compliance with GFD was based on the pathohistological findings of the small bowel mucosa or determination of tissue transglutaminase. Results. Over the studied period, the effect of GFD was highly significant, both on the increase of BH percentiles (37.62?26.26 vs. 57.22?25.29; p<0.001), and on the decrease of BW deficit 11.58?10.80 vs. 0.89?8.194; p<0.001). After the treatment period, none of the children showed slowed growth rate or BW deficit above 20%, while BW deviation ranging between 10-20% in relation to the referent values was registered in 17 (18.19%) and the excess of over 20% in 2 patients. In 86 (95.56%) patients, control Hb values in blood were normal, while mild anaemia was registered in 4 patients, all compliant with GFD. The difference between the compliant and non-compliant patients with GFD was not detected either in BH percentiles (p=0.586) or in BW percentage deviation as compared to standard values (p=0.516) or in blood Hb values (p=0.445). In addition, differences between the children on GFD lasting over and below 3 years were not detected either in BH percentiles (p=0.915) or in BW deviation percentages in relation to the ideal rate (p=0.476). Conclusion. GFD applied for 1-3 years has a highly significant effect on the growth rate and nutritional status of children with the classical form of CD. Significant differences in these parameters of the disease were not detected between strictly compliant and non-compliant patients on GFD.

scholarly journals Celiac disease in children - modern diagnostic approach

2008 ◽  
Vol 136 (Suppl. 2) ◽  
pp. 152-157
Author(s):  
Nedeljko Radlovic
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Diagnostic Value ◽  
Iga Deficiency ◽  
Elimination Diet ◽  
Gluten Free Diet ◽  
Permanent Teeth ◽  
Gluten Free ◽  
Small Bowel Mucosa ◽  
Bowel Mucosa

Celiac disease presents a hereditary disorder of gluten tolerance, i.e. of gliadin and related prolamins of wheat, rye and barley. It primarily occurs in Caucasians (1:100-300), while it is considerably or exceptionally rare in colored races. It is particularly frequent in close relatives of the patient, as well as in persons with congenital IgA deficiency and in patients with autoimmune and some chromosomal diseases. The basis of the disease, as well as the key finding in its diagnostics, lies in small bowel inflammation, which withdraws on gluten free diet. Beside clinically manifest or non-manifest enteropathy, changes involving other organs and systems are also frequently seen. The diagnosis of the manifest form of the disease is based on characteristic pathohistological finding detected by the examination of small bowel mucosa in patients on standard diets and their clinical improvement after the introduction of gluten free diet. However, in the diagnosis of the asymptomatic form of the disease, it is necessary to perform enterobiopsy, which confirms the normalization of the appearance of small bowel mucosa in patients on the elimination diet. In children with gluten sensitive enteropathy detected in the first two years of life, as well as in cases in which mucosa samples taken on the first enterobiopsy do not have typical appearance or are inadequate for a reliable interpretation, a definite diagnosis is made based on biopsy finding during the provocation of gluten tolerance. As the quality of permanent teeth can be disturbed, this procedure is not suggested to be done before the completed age of 6 years, and due to adverse effects on the growth and development of the child, it should not be done during puberty. Due to incomplete sensitivity and specificity, the serological indicators of the disease do not have diagnostic value. Therefore, they are primarily used in the disclosure of asymptomatic and atypical forms of celiac disease, as well as in the assessment of the consistency of elimination diet in cases with already verified disease. In addition, the application of these tests makes easier passing the decision to perform pathohistological examination of small bowel mucosa in patients with provoked gluten tolerance, which also gives a more complete understanding into the remission of the disease during the initial phase of treatment.

Density of γ/δ T cells in small bowel mucosa related to HLA-DQ status without coeliac disease

The Lancet ◽  
1993 ◽  
Vol 342 (8869) ◽  
pp. 492-493 ◽  
Author(s):  
K.N. Chan ◽  
A.D. Phillips ◽  
J.A. Walker-Smith ◽  
S. Koskimies ◽  
J. Spencer
Keyword(s):  
T Cells ◽  
Small Bowel ◽  
Coeliac Disease ◽  
Hla Dq ◽  
Small Bowel Mucosa ◽  
Bowel Mucosa

The Toxic Effect of Gliadin Fractions on the Small Bowel Mucosa of Patients with Coeliac Disease

1982 ◽  
Vol 62 (2) ◽  
pp. 48P-48P ◽  
Author(s):  
P.J. Ciclitira ◽  
D.J. Evans ◽  
E.S. Lennox ◽  
N.L.K. Fagg ◽  
R.H. Dowling
Keyword(s):  
Small Bowel ◽  
Coeliac Disease ◽  
Toxic Effect ◽  
Small Bowel Mucosa ◽  
Bowel Mucosa

scholarly journals Growth and glycemic control in children with type 1 diabetes and asymptomatic celiac disease treated with a gluten -free diet for 1 year

2019 ◽  
Vol 17 ◽  
pp. 205873921985557
Author(s):  
Maria Giulia Berioli ◽  
Giulia Mancini ◽  
Nicola Principi ◽  
Elisa Santi ◽  
Martina Ascenzi ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Glycemic Control ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Age And Gender ◽  
The Mean ◽  
And Gender ◽  
Nutritional Status Of Children

To compare growth and glycemic control in children with type 1 diabetes and silent celiac disease treated with a gluten-free diet for 1 year with those of similar age and gender with type 1 diabetes but without celiac disease, 16 type 1 diabetes patients with silent celiac disease were enrolled and each celiac disease-positive case was matched for age, sex, and duration of diabetes with two type 1 diabetes controls with negative serologic markers of celiac disease. All 16 children with positive celiac disease serology had histologic features consistent with celiac disease despite the absence of symptoms. The mean growth and metabolic control values were similar between children with type 1 diabetes and celiac disease and those with type 1 diabetes but without celiac disease. This study seems to suggest that the early diagnosis of celiac disease and initiation of a gluten-free diet may prevent further deterioration in the nutritional status of children with type 1 diabetes and celiac disease and may reduce the prospect of celiac disease complications without any impact on type 1 diabetes control.

Increased FOXP3 expression in small-bowel mucosa of children with coeliac disease and type I diabetes mellitus

2009 ◽  
Vol 44 (4) ◽  
pp. 422-430 ◽  
Author(s):  
Tamara Vorobjova ◽  
Oivi Uibo ◽  
Kaire Heilman ◽  
Tiina Rägo ◽  
Jarno Honkanen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Small Bowel ◽  
Coeliac Disease ◽  
Type I Diabetes ◽  
Foxp3 Expression ◽  
Type I Diabetes Mellitus ◽  
Type I ◽  
Small Bowel Mucosa ◽  
Bowel Mucosa

scholarly journals Tolerance to oats in dermatitis herpetiformis

Gut ◽  
1998 ◽  
Vol 43 (4) ◽  
pp. 490-493 ◽  
Author(s):  
T Reunala ◽  
P Collin ◽  
K Holm ◽  
P Pikkarainen ◽  
A Miettinen ◽  
...  
Keyword(s):  
Small Bowel ◽  
Dermatitis Herpetiformis ◽  
Clinical Symptoms ◽  
Cell Receptor ◽  
Gluten Free Diet ◽  
Control Group ◽  
Gluten Free ◽  
Serum Samples ◽  
Before And After ◽  
Small Bowel Mucosa

Objectives—Recent studies on coeliac disease have shown that oats can be included in a gluten-free diet without adverse effects on the small bowel. The presence of a rash is also a sensitive indicator of gluten ingestion in dermatitis herpetiformis, and this was used to study whether patients with this disease could also tolerate oats.Patients/Methods—Eleven patients with dermatitis herpetiformis in remission on a gluten-free diet were challenged daily with 50 g oats for six months. Clinical symptoms were recorded, serum samples taken, and skin and small bowel biopsies performed before and after the oat challenge. A control group comprised of 11 patients with dermatitis herpetiformis on a conventional gluten-free diet was also studied.Results—Eight patients challenged with oats remained asymptomatic, two developed a transient rash, and one withdrew because of the appearance of a more persistent but mild rash. Three of the 11 controls also developed a transient rash. IgA endomysial antibodies remained negative in all patients. The small bowel villous architecture, the densities of intraepithelial CD3 and α/β and γ/δ T cell receptor positive lymphocytes and crypt epithelial cell DR expression remained unaltered during the oat challenge.Conclusions—The results confirm the absence of oat toxicity on the gluten sensitive small bowel mucosa and suggest that the rash in patients with dermatitis herpetiformis is not activated by eating oats.

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