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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249


MENDEZ, Virginia et al. Enfermedad celíaca en el niño: los tests de provocación cortos con gluten son útiles porque disminuyen la severidad de los síntomas. Arch. Pediatr. Urug. [online]. 2007, vol.78, n.4, pp.265-269. ISSN 1688-1249.

A prospective study was performed to determine the usefulness of short gluten challenge tests for the diagnosis of Celiac Disease. 42 children were enrolled who had consulted the Child Gastroenterology Department A of the CHPR and DEMEQUI between 1981 and 1992. They all had celiac disease symptoms. The first biopsy showed severe bowel disease, which was followed by clearance of symptoms when put on a gluten-free diet; the second biopsy was normal or showed mild lesions after removing gluten from the diet for an average time of 17 months (range 10 months-10 years); mode: 12 months. At the time of the gluten challenge, the children (36 girls and 16 boys) had an average age of 6 years (ranging from 3 years + 4 months to 14 years). Challenge was done by mixing wheat flour (45 to 135 gr/day) in the preparation of their usual food for 7 weeks (ranging from 6-48 weeks), and a 6-week mode. Children were controlled clinically and symptoms were recorded in a pre-coded card. Most children (35/42), presented very subtle symptoms. One post-challenge biopsy was done in 40 children, two biopsies in one child and three biopsies in one (these two last children received the lowest amounts of gluten). In 30/42 the biopsy showed a severe lesion, in nine it was moderate and in three the exact height of the villi could not be evaluated, but there were histology changes definitely confirming the diagnosis. We conclude that gluten challenge tests are useful and that they should be done under strict control. At present they should be complemented with serology testing to determine the timeliness of the third biopsy more exactly.

Keywords : CELIAC DISEASE-diagnosis;  GLUTEN; INTESTINE, SMALL-pathology;  BIOPSY.

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