Gluten-sensitive enteropathy: value of oral triglyceride loading test in the follow-up of patients on gluten challenge.

Oral triglyceride (TG) loading tests were performed in 31 patients with gluten-sensitive enteropathy (GSE) upon gluten challenge, and the results were compared with the mucosal histology. Of 19 prechallenge tests, 16 were in the normal range previously established in this laboratory (2-h postcibal plasma TG rise greater than or equal to 55 mg/dl) although values were lower (76 +/- 38 mg/dl, mean +/- SD) than those of healthy age-matched controls (116 +/- 34 mg/dl). Postchallenge tests performed in 29 patients (both symptomatic and asymptomatic) were all pathologic (postcibal TG rise 9 +/- 18 mg/dl). Three tests performed in two patients in whom GSE was ultimately not confirmed remained normal (postcibal TG rise 82 +/- 21 mg/dl) during a 24-mo follow-up. A significant correlation was demonstrated between the TG loading test and the mucosal pathology. The test is useful in the follow-up of patients of gluten challenge and in directing the postchallenge biopsy.