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What Happens to Kids with Potential Celiac Disease Who Eat Gluten?

Celiac.com 09/03/2014 - What’s potential celiac disease, and what happens to kids who have it and continue to eat a gluten-containing diet?

Researchers define potential celiac disease as the presence of serum anti-tissue-transglutaminase (anti-TG2) antibodies with normal duodenal mucosa. That is, a positive blood screen, but no intestinal damage. However, not much is known about potential celiac disease because people who have it often show no obvious symptoms. Patients with potential celiac disease present some challenges for doctors trying to determine how likely it is that these patients will develop villous atrophy, the gut damage common in celiac disease patients exposed to gluten.

Photo: CC--Chad MillerA research team conducted a prospective longitudinal cohort study to follow patients with potential celiac disease up to 9 years, and explore the risk factors tied to mucosal damage. The research team included Renata Auricchio MD, PhD, Antonella Tosco MD, Emanuela Piccolo MD, Martina Galatola PhD, Valentina Izzo PhD, Mariantonia Maglio PhD, Francesco Paparo PhD, Riccardo Troncone MD, PhD, and Luigi Greco MD, PhD. They are affiliated with the Department of Medical Translational Science, European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy.

For their study, the team found two hundred and ten asymptomatic children with potential celiac disease. They kept 175 of them on a gluten-containing diet. To evaluate histological, immuno-histochemical, and anti-TG2 status, they checked blood antibody levels and clinical symptoms every 6 months, and took a small bowel biopsy every two years. They also genotyped all patients for HLA and non-HLA celiac-associated genes.

Forty-three percent of patients showed persistently elevated anti-TG2 levels, 20% became negative during follow-up, and 37% showed variations in anti-TG2 course, with many patients testing at zero anti-TG2.

After three years of follow-up, 86% of study patients continued to have potential celiac disease. After 6 and 9 years, respectively, 73% and 67% of study patients still had normal duodenal structure.

Individuals prone to develop mucosal damage during the test period were predominantly male, had slight mucosal inflammation at study’s start, and fit a peculiar genetic profile.

Nine years after follow-up, a large number of patients with asymptomatic potential celiac disease showed reduced antibody production, many even showing zero production, and many of these, with persistently positive anti-TG2, showed no mucosal damage.

Given the results of this study, and noting that the celiac population is in fact made up of numerous individuals with diverse genetic and phenotypic makeup, the researchers are advising doctors to be cautious in prescribing a strict lifelong gluten-free diet for asymptomatic individuals with potential celiac disease.

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8 Responses:

 
Richard Duvall
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said this on
08 Sep 2014 3:31:52 PM PST
I'm wondering if the phrase "researchers are advising doctors to be cautious in prescribing a strict lifelong gluten-free diet for asymptomatic individuals with potential celiac disease" means they should be cautious by prescribing a GFD although it may make no difference, or does it mean doctors should be cautious before prescribing a diet that will be a lifelong burden to someone who may not need it?

 
Diane
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said this on
08 Sep 2014 3:36:00 PM PST
The next question is: What happens to those same people at age 20, age 30, age 40, etc. Are they more or less likely to develop full-blown CD?

 
Michael
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said this on
08 Sep 2014 6:23:53 PM PST
The doctors who recommend these children continue to eat gluten are woefully ignorant and dangerous to society, because they have no clue that all organs will eventually become targets of the immune systems of those with anti tTG, as will those of their children and their children. The central nervous systems and endocrine systems are more vulnerable and more often the target of the gluten sensitive immune systems than the intestinal mucosa.

 
Martina
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said this on
20 Sep 2014 3:23:50 AM PST
Couldn't agree more!

 
ginny
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said this on
03 Jul 2015 8:07:39 PM PST
I have CD and hardly ever ate gluten before finding out and had a lot of organ issues !!!

 
celiacMom
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said this on
10 Sep 2014 8:51:57 AM PST
Seems like good research, hope they do more like this to keep knowledge moving forward.

 
Robin
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said this on
11 Sep 2014 9:26:21 PM PST
Too bad this is not written in everyday English that the average layman can understand. Those of us with children who have celiac would like to learn something helpful to contribute to our children's good health.

 
Jefferson
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said this on
16 Sep 2014 8:44:22 AM PST
If your child actually has celiac disease, then this article is not relevant to their health or medical condition. As for your level of comprehension, other "laymen" readers and those making comments don't seem to have the same problem, but keep reading such articles, and perhaps you will learn to understand them better.




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