Mucosal healing in children with treated celiac disease

Youssef Ghazzawi, Alberto Rubio-Tapia, Joseph A Murray, Imad Absah

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives: Limited data suggest complete mucosal healing in treated children with celiac disease (CD), but recent data from adult endoscopic biopsies have shown substantial numbers with persistent mucosal injury. We aimed to assess the rate of mucosal healing and indications for repeat small bowel (SB) biopsy in children with CD. Methods: We retrospectively reviewed records of children (ages 1-18 years) with CD who underwent a second SB biopsy. All of the children were seen at Mayo Clinic (Rochester, MN) from January 1997 through June 2013. Results: Forty children were identified (14 boys); average age at diagnosis was 8.5 years. Indications for second SB biopsy were abdominal pain (n=20), diarrhea (n=7), constipation (n=5), non-celiac-related concern (n=2), follow-up (n=5), and persistent serology (n=1). Average time between biopsies was 24 months (range 4-120 months). Histology on the second biopsy showed complete healing (n=25), intraepithelial lymphocytes (n=9), and persistent villous atrophy (n=6). Of these, 3 patients had partial villous atrophy and 3 had with complete villous atrophy. Persistent villous atrophy was observed in 2 of 20 patients with abdominal pain and 1 of 7 with diarrhea. All of the patients with persistent constipation (n=5) had complete resolution. Conclusions: Mucosal healing in children with CD may not be complete as previously assumed. Abdominal pain was the most common indication for repeating the SB biopsy. Persistence of abdominal pain, diarrhea, and constipation was poorly associated with persistence of mucosal injury.

Original languageEnglish (US)
Pages (from-to)229-231
Number of pages3
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume59
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Celiac Disease
Biopsy
Abdominal Pain
Atrophy
Constipation
Diarrhea
Wounds and Injuries
Serology
Histology
Lymphocytes

Keywords

  • celiac
  • gluten
  • mucosa
  • pain
  • villous atrophy

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Mucosal healing in children with treated celiac disease. / Ghazzawi, Youssef; Rubio-Tapia, Alberto; Murray, Joseph A; Absah, Imad.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 59, No. 2, 2014, p. 229-231.

Research output: Contribution to journalArticle

Ghazzawi, Youssef ; Rubio-Tapia, Alberto ; Murray, Joseph A ; Absah, Imad. / Mucosal healing in children with treated celiac disease. In: Journal of Pediatric Gastroenterology and Nutrition. 2014 ; Vol. 59, No. 2. pp. 229-231.
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