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How Fast do Celiac Kids Recover on a Gluten-free Diet?

If kids with celiac disease go on a gluten-free diet, how quickly does their serology return to normal?


How long does it take for serology to normalize in celiac children on a gluten-free diet? Photo: CC--Hannenah710

Celiac.com 11/23/2016 - Researchers know that kids with celiac disease have fully responded to a gluten-free diet when symptoms resolve and serology returns to normal.

A team of researchers recently set out to assess the rate of normalization of the TTG and EMA for children on a gluten-free diet after diagnosis. The researchers included Dominica Gidrewicz, Cynthia L Trevenen, Martha Lyon, and J Decker Butzner.

After initiated a gluten-free diet in 228 newly diagnosed children with biopsy-proven celiac disease, the team obtained and recorded celiac serologies over a 3.5 year period.

The team categorized patients based on serology (Group A, TTG >= 10 x upper limit of normal (ULN) and EMA >= 1:80; Group B, TTG >= 10 x ULN and EMA and EMA <= 1:40; and Group C, TTG < 10 x ULN) and by severity of histologic injury at diagnosis.

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They found that in children in Group A showed the highest serology at diagnosis. Of those, 79.7% had abnormal TTG at 12 months after diagnosis (average TTG 12 mo, 68.8 +/- 7.3, normal < 20 kU/L).

At two years, abnormal TTG persisted in 41.7% of Group A. By contrast, in Group C, which showed the lowest serology at diagnosis, only 35% of children displayed an abnormal TTG at 12 months (average TTG 14.3 +/- 1.9 kU/L). In kids with the most severe mucosal damage, Marsh 3C, 74.2% and 33.2% had an abnormal TTG at 1 and 2 year.

The data in this study indicate that 3 out of 4 gluten-free diet compliant kids with the highest celiac serology or most severe mucosal injury at diagnosis, took longer than one year in for serology to return to normal.

Doctors should take serology and histology into consideration at diagnosis in order to properly assess the patient's response to the gluten-free diet. That said, it's encouraging that even the more severe cases of celiac disease will eventually return to normal when the kids follow a gluten-free diet.

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Morning guys. So long story short. Lost 10 kg back late last year. Stress related I believe. ( I Understand this is a big factor with celiacs) Tested. Found anti bodies in my blood. Doctor states potential Celiacs. Have endoscopy. Doctor who takes procedure doubts I have it. ...

Getting a celiac disease diagnosis is shocking. Expect to go through all the stages of grief. Your best defense is to learn how to read labels, avoid cross contamination and consider eating as few processed foods for a few weeks. It may speed healing (wish someone would have advised me to do s...

That is very helpful. Thank you so much.

I would read it as ?high?. In any case, you were positive on the TTG and the DGP. You only need one positive. I had pretty severe intestinal damage and never even had a positive on the EMA or the TTG even when they were re-run several times during follow-up visits.

Thank you! That does help. I was just confused about the ?negative? under the EMA Titer when my level says ?1:40 high?. Any insight there? Just wondering if it?s further confirming or denying? I first thought confirming.