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J Pediatr. 2014 Mar;164(3):463-7.e1. doi: 10.1016/j.jpeds.2013.10.007. Epub 2013 Nov 16.

Clinical, serologic, and histologic features of gluten sensitivity in children.

Author information

1
Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy. Electronic address: rfrancavilla@gmail.com.
2
Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy.
3
Department of Pediatrics, San Paolo Hospital, Bari, Italy.
4
Department of Pediatrics, Rovereto Hospital, Rovereto, Italy.
5
Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.
6
Tandoi Group, Corato, Italy.

Abstract

OBJECTIVE:

To describe the clinical, serologic, and histologic characteristics of children with gluten sensitivity (GS).

STUDY DESIGN:

We studied 15 children (10 males and 5 females; mean age, 9.6 ± 3.9 years) with GS who were diagnosed based on a clear-cut relationship between wheat consumption and development of symptoms, after excluding celiac disease (CD) and wheat allergy, along with 15 children with active CD (5 males and 10 females; mean age, 9.1 ± 3.1 years) and 15 controls with a functional gastrointestinal disorder (6 males and 9 females; mean age, 8.6 ± 2.7 years). All children underwent CD panel testing (native antigliadin antibodies IgG and IgA, anti-tissue transglutaminase antibody IgA and IgG, and anti-endomysial antibody IgA), hematologic assessment (hemoglobin, iron, ferritin, aspartate aminotransferase, erythrocyte sedimentation rate), HLA typing, and small intestinal biopsy (on a voluntary basis in the children with GS).

RESULTS:

Abdominal pain was the most prevalent symptom in the children with GS (80%), followed by chronic diarrhea in (73%), tiredness (33%), bloating (26%), limb pain, vomiting, constipation, headache (20%), and failure to thrive (13%). Native antigliadin antibodies IgG was positive in 66% of the children with GS. No differences in nutritional, biochemical, or inflammatory markers were found between the children with GS and controls. HLA-DQ2 was found in 7 children with GS. Histology revealed normal to mildly inflamed mucosa (Marsh stage 0-1) in the children with GS.

CONCLUSION:

Our findings support the existence of GS in children across all ages with clinical, serologic, genetic, and histologic features similar to those of adults.

PMID:
24252792
DOI:
10.1016/j.jpeds.2013.10.007
[Indexed for MEDLINE]
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