Transient gluten intolerance.

An infant presented with hypoproteinaemic oedema two months after an episode of salmonella enteritis. His oedema subsided spontaneously, but he failed to thrive and small bowel biopsy revealed partial villous atrophy of a severe degree. He was started on a gluten-free diet with a dramatic clinical response and this diet was continued for one year. He was then reinvestigated and small intestinal biopsy was then normal. He was then given a normal diet and a third biopsy performed 16 months later showed that the mucosa was still normal. It is suggested that a transient intolerance to gluten occurred in this patient as a sequel to enteritis, and that a clinical response to a gluten-free diet is not necessarily diagnostic of coeliac disease.