[Can serologic markers be indicators of dietary errors in patients with celiac disease?]

Coeliac disease is a disease of small intestine requiring life-long strict gluten free diet to avoid acute and chronic complications. To reach maximum adherence to the diet is in some of coeliac patients, especially adults, difficult because it requires distinct changes in eating habits. To diagnose coeliac disease tests of antigliadin and anti-endomysial antibodies in serum are used. Authors monitored levels of antibodies in 32 adults 3, 6, and 12 month after histology validation of coeliac disease and after recommendation of a gluten free diet. The results were compared with data from nutritional history. Maximum adherence to the diet indicated 24 patients (75%), occasional consummation of gluten indicated 6 patients (19%) and more frequent breaking a diet indicated 2 patients (6%). In a group which adhered to the diet the most rapid was a decline in levels of anti-endomysial antibodies, less rapid was a decline in levels of IgA-class antigliadin antibodies, and the least rapid was a decline in levels of IgG-class antigliadin antibodies. In the group with occasional intake of gluten was the decline slower and in the group with frequent dietary mistakes levels of antibodies have not declined at all. Adherence to the diet positively correlated with level of accomplished education of patients. Monitoring of titter kinetics proved to be a good indicator of discipline and cooperation of patients during treatment with gluten free diet.