Abstract
Thirty-five children, in whom coeliac disease had been diagnosed on inadequate grounds and who had been on a gluten-free diet for one to 10 years, were challenged with gluten in accordance with a standardised procedure. All children were admitted to hospital for 48 hours for general assessment, two one-hour blood xylose tests, and the introduction of gluten. Thirty children underwent a pre-challenge peroral jejunal mucosal biopsy; the specimens were either normal or showed slight non-specific abnormalities. Gluten powder 20 g/day was given in addition to an otherwise gluten-free diet. The children were reassessed as outpatients every two weeks, when a one-hour blood xylose test was performed. Repeat biopsy was performed when xylose absorption fell or after three months. Seventeen children had abnormal post-challenge biopsy appearances compatible with coeliac disease in relapse; 14 of these children completed their challenge within eight weeks. Seventeen children had completely normal biopsy appearances at the end of three months and were returned to a normal diet. One to two years later eight underwent repeat biopsies, which showed nothing abnormal. In only one child, the oldest in the series, were the histological findings equivocal. In the 17 children in whom coeliac disease was confirmed the duration of gluten challenge was not related to age, duration of gluten-free diet, histological findings on the pre-challenge biopsy, or HLA status.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Hamilton J. R., McNeill L. K. Childhood celiac disease: response of treated patients to a small uniform daily dose of wheat gluten. J Pediatr. 1972 Nov;81(5):885–893. doi: 10.1016/s0022-3476(72)80538-9. [DOI] [PubMed] [Google Scholar]
- Kendall M. J., Nutter S., Hawkins C. F. Testing gluten sensitivity by the xylose test. Lancet. 1972 Mar 25;1(7752):667–668. doi: 10.1016/s0140-6736(72)90466-7. [DOI] [PubMed] [Google Scholar]
- Lamabadusuriya S. P., Packer S., Harries J. T. Limitations of xylose tolerance test as a screening procedure in childhood coeliac disease. Arch Dis Child. 1975 Jan;50(1):34–39. doi: 10.1136/adc.50.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McNeish A. S., Anderson C. M. Coeliac disease. The disorder in childhood. Clin Gastroenterol. 1974 Jan;3(1):127–144. [PubMed] [Google Scholar]
- McNeish A. S., Nelson R., Mackintosh P. H-LA 1 and 8 in childhood coeliac disease. Lancet. 1973 Mar 24;1(7804):668–668. doi: 10.1016/s0140-6736(73)92234-4. [DOI] [PubMed] [Google Scholar]
- Packer S., Rowlatt R. J., Harries J. T. Proceedings: Reappraisal of a past diagnosis of "coeliac disease". Arch Dis Child. 1974 Oct;49(10):819–819. doi: 10.1136/adc.49.10.819-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rolles C. J., Anderson M., McNeish A. S. Confirming persistence of gluten intolerance in children diagnosed as having coeliac disease in infancy. Arch Dis Child. 1975 Apr;50(4):259–263. doi: 10.1136/adc.50.4.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rolles C. J., Kendall M. J. Gluten provocation and the xylose test in adolescents. Lancet. 1973 Aug 18;2(7825):381–381. doi: 10.1016/s0140-6736(73)93227-3. [DOI] [PubMed] [Google Scholar]
- Rolles C. J., Kendall M. J., Nutter S., Anderson C. M. Letter: Reappraisal of the xylose test. Arch Dis Child. 1975 Sep;50(9):748–749. doi: 10.1136/adc.50.9.748. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rolles C. J., Nutter S., Kendall M. J., Anderson C. M. One-hour blood-xylose screening-test for coeliac disease in infants and young children. Lancet. 1973 Nov 10;2(7837):1043–1045. doi: 10.1016/s0140-6736(73)92656-1. [DOI] [PubMed] [Google Scholar]
- Young W. F., Pringle E. M. 110 children with coeliac disease, 1950-1969. Arch Dis Child. 1971 Aug;46(248):421–436. doi: 10.1136/adc.46.248.421. [DOI] [PMC free article] [PubMed] [Google Scholar]