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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.

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Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy. Electronic address:
Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy.
Department of Pediatrics, San Paolo Hospital, Bari, Italy.
Department of Pediatrics, Rovereto Hospital, Rovereto, Italy.
Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.
Tandoi Group, Corato, Italy.



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


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).


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.


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

[Indexed for MEDLINE]

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