Mandile Roberta, Discepolo Valentina, Scapaticci Serena, Del Vecchio Maria Rosaria, Maglio Maria Antonia, Greco Luigi, Troncone Riccardo, Auricchio Renata
Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy.
J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):654-656. doi: 10.1097/MPG.0000000000001745.
In this prospective study, we evaluated the effect of gluten-free diet (GFD) in a cohort of 65 children with potential celiac disease. Patients received GFD for signs/symptoms (N = 47) or parents' choice (N = 18). Most frequent signs/symptoms were low body mass index (36%), recurrent abdominal pain (34%), and diarrhea (19%). Of the 35/47 patients followed-up on GFD, only 54% (19/35) showed a complete clinical response. In 9 of 65 patients an intestinal biopsy was also performed after at least 1 year of GFD. No significant differences were observed in terms of Marsh grade (P = 0.33), lamina propria CD25+ cells (P = 0.80), CD3+ (P = 0.9), and γδ+ (P = 0.59) intraepithelial lymphocytes density and intestinal anti-TG2 deposits (P = 0.60). In conclusion, caution is necessary before attributing all symptoms to gluten in this condition.
在这项前瞻性研究中，我们评估了无麸质饮食（GFD）对65名潜在乳糜泻儿童队列的影响。患者因体征/症状（N = 47）或家长选择（N = 18）接受无麸质饮食。最常见的体征/症状是低体重指数（36%）、反复腹痛（34%）和腹泻（19%）。在47名接受无麸质饮食随访的患者中，只有54%（19/35）表现出完全的临床反应。65名患者中有9名在接受至少1年无麸质饮食后也进行了肠道活检。在马什分级（P = 0.33）、固有层CD25 +细胞（P = 0.80）、CD3 +（P = 0.9）和γδ +（P = 0.59）上皮内淋巴细胞密度以及肠道抗TG2沉积物（P = 0.60）方面未观察到显著差异。总之，在这种情况下，将所有症状归因于麸质之前必须谨慎。
