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[Long-term follow up study of children with celiac disease]
1Fövárosi Onkormányzat Budai Gyermekkórház, Semmelweis Orvostudományi Egyetem, Budapest.
Insights
A strict gluten-free diet is crucial for children with coeliac disease to manage antibody levels and reduce malignancy risk. Long-term monitoring of gliadin antibodies and serum ferritin is important for diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Nutrition Science
Context:
- Coeliac disease (CD) management in children requires long-term adherence to a gluten-free diet (GFD).
- Assessing the impact of varying GFD strictness on clinical and biochemical markers in pediatric CD patients.
- Understanding the long-term implications of GFD adherence on growth, symptoms, and disease markers.
Purpose:
- To evaluate the long-term effects of different gluten-free diet (GFD) adherence levels in children with coeliac disease.
- To assess the relationship between diet strictness, gliadin antibody levels, serum ferritin, and lactose intolerance.
- To determine the significance of monitoring specific biomarkers for coeliac disease management and risk assessment.
Summary:
- This study followed 27 children with coeliac disease for an average of 6.4 years.
- Dietary adherence varied, with some children on strict, semi-strict, or normal diets, impacting gliadin antibody and serum ferritin levels.
- While weight and length percentiles showed no difference, a strict diet is emphasized due to malignancy risk, with gliadin antibodies and ferritin being key diagnostic indicators.
Impact:
- Highlights the critical role of strict gluten-free diet adherence in pediatric coeliac disease for mitigating long-term risks, including malignancy.
- Establishes the diagnostic and prognostic value of monitoring gliadin antibodies and serum ferritin levels in long-term coeliac disease follow-up.
- Provides insights into the management of coeliac disease in children, informing clinical practice regarding dietary recommendations and monitoring strategies.
Abstract:
27 long term monitored coeliac children were assessed. The average length of follow-up was 6.4 years, the average age of the children was 11.5 years (ranging 6.3 to 20.1 years). Of the 11 boys and 16 girls 4 adolescents consume a normal diet, while another 2 are on semistrict diet, all 6 of them without any enteral symptoms. Out of the 15 children aged younger than 13 years 9 are on a strict diet. Semistrict diet has an impact on gliadin antibody levels respectively. Serum ferritin levels of those on a normal diet are significantly lower than those of the control group. Out of the 25 lactose breath tests 7 showed abnormal results, irrelevant both to the strictness of the diet and to gliadin antibody levels. In the view of weight and length percentiles there is no difference at present between those eating normal food and diet. Nevertheless, with regards to the risk of malignancy in coeliac disease the necessity of a strict diet must be stressed. In long term follow-up the levels of gliadin antibodies and of serum ferritin are of pathognostic importance.