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Assessing Mucosal Recovery During the First 15 Months of Adopting a Gluten-Free Diet in Children With Celiac Disease
Denis Chang1,2, Madison Wong1,2, Cleo R Davidowitz1,3
1Harvard Celiac Research Program, Harvard Medical School, Boston, Massachusetts, USA.
Insights
Early mucosal recovery in pediatric celiac disease (CeD) is achievable, but over a quarter of children still show persistent enteropathy within 15 months of treatment. Musculoskeletal symptoms at diagnosis may indicate slower healing.
Area of Science:
- Pediatric Gastroenterology
- Celiac Disease Research
- Gastrointestinal Mucosal Healing
Background:
- Celiac disease (CeD) diagnosis in children requires monitoring of intestinal healing.
- Contemporary data on early mucosal recovery rates in pediatric CeD are limited.
Purpose of the Study:
- To determine current rates of early mucosal recovery in children diagnosed with celiac disease.
- To identify factors associated with persistent enteropathy.
Main Methods:
- Multicenter retrospective cohort study conducted in Canada and the United States.
- Included children diagnosed with CeD between 2016 and 2021.
- Follow-up duodenal biopsies were analyzed within 15 months of diagnosis.
Main Results:
- Mucosal recovery was observed in 74% (96/130) of children.
- Early assessment (within 3 months) showed recovery in 48% (12/25) of children.
- Musculoskeletal symptoms at diagnosis were the sole clinical predictor of persistent enteropathy.
Conclusions:
- While prompt mucosal recovery is possible in pediatric celiac disease, a significant proportion experience delayed healing.
- Persistent enteropathy affects over 25% of children within 15 months of treatment initiation.
- Identifying children at risk for slower recovery, such as those with initial musculoskeletal symptoms, is crucial.
Introduction:
Determine contemporary rates of early mucosal recovery in children with celiac disease (CeD).
Methods:
Multicenter retrospective cohort study in Canada and the United States. Children diagnosed with CeD between 2016 and 2021 who underwent a follow-up biopsy within 15 months of diagnosis were included.
Results:
Overall, 96 of 130 children (74%) had mucosal recovery, including 48% children (12/25) who were assessed within 3 months. Musculoskeletal symptoms at diagnosis were the only clinical characteristic associated with persistent enteropathy.
Discussion:
While mucosal recovery can occur within months, more than a quarter of children with CeD had persistent enteropathy within 15 months of treatment.
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