Related Experiment Videos
Coeliac disease associated with congenital heart disease
Insights
Poor growth in children with congenital heart disease may indicate gluten enteropathy. A gluten-free diet improved growth in six patients, suggesting early jejunal biopsy is crucial for diagnosis.
Area of Science:
- Pediatric Cardiology
- Gastroenterology
- Pediatric Nutrition
Background:
- Congenital heart disease (CHD) can be associated with growth failure.
- Small-bowel villous atrophy is a potential, often overlooked, cause of poor growth in children.
Purpose of the Study:
- To investigate the link between congenital heart disease and gluten enteropathy.
- To assess the impact of a gluten-free diet on growth in children with CHD and villous atrophy.
Main Methods:
- Case series describing six children with CHD and poor growth.
- Diagnosis of villous atrophy confirmed via jejunal biopsy.
- Treatment involved a gluten-free diet.
Main Results:
- All six children exhibited small-bowel villous atrophy as the cause of poor growth.
- None of the children were in heart failure, and only one had severe cyanosis.
- Significant growth improvement was observed in all patients after initiating a gluten-free diet.
Conclusions:
- Gluten enteropathy may be more prevalent in children with CHD than previously recognized.
- Jejunal biopsy is recommended for children with CHD and unexplained poor growth, especially without severe cardiac symptoms.
- Early diagnosis and dietary intervention can improve growth outcomes in this population.
Abstract:
Six children with congenital heart disease are described in whom poor growth was found to be due to small-bowel villous atrophy; none was in heart failure and only one was severely cyanosed. Growth improved in all 6 on a gluten-free diet. Gluten enteropathy may be more common than is realised in children with congenital heart disease, and jejunal biopsy should be undertaken early in any patient with poor growth and no heart failure to exclude the coexistence of the condition.