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Is celiac disease a lifelong disorder?
1Department of Pediatrics, Hôpital des Enfants Malades, Paris.
Summary
Celiac disease may not be lifelong. Some children develop gluten tolerance, and adult-onset celiac disease is possible, suggesting the condition can appear and disappear in predisposed individuals.
Area of Science:
- Gastroenterology
- Immunology
- Human Biology
Background:
- Celiac disease was historically considered a lifelong autoimmune disorder characterized by intestinal mucosal damage in response to gluten.
- Diagnosis and management traditionally involved intestinal biopsies and gluten withdrawal, with challenges confirming lifelong sensitivity.
Purpose of the Study:
- To re-evaluate the lifelong nature of celiac disease based on recent evidence.
- To explore the evolving understanding of celiac disease's long-term course and potential for remission.
Main Methods:
- Review of long-term follow-up data of children diagnosed with celiac disease.
- Analysis of case studies documenting adult-onset celiac disease.
- Examination of evolving clinical, biological, and histological criteria for gluten tolerance.
Main Results:
- 10-20% of children with celiac disease achieve clinical, biological, and histological tolerance to gluten during adolescence.
- Adult-onset celiac disease has been observed, indicating disease onset later in life.
- These findings challenge the notion of celiac disease as a permanently lifelong condition.
Conclusions:
- Celiac disease may develop and, in some individuals, resolve in genetically predisposed populations with intestinal gluten sensitivity.
- The factors influencing the onset or remission of celiac disease remain largely unknown and require further investigation.