In a new study, one-third of children biopsied showed villous atrophy by 3-year follow-up.
Researchers have discovered new evidence supporting the well-known fact that celiac disease can develop at any age.
A recent study observed children with potential celiac disease, a term used to identify children with positive serology for celiac disease but a normal small intestinal biopsy. Conducted in Italy, the researchers found that while many of the children did not initially have symptoms despite positive blood work, one-third of those who underwent re-biopsy showed signs of villous atrophy within 3 years.
The Italian researchers followed 106 children with potential celiac disease over the course of 3 years. The children were selected based on a positive antibody test. Of the participants, 40% were first-degree relatives of diagnosed celiacs or patients with autoimmune disorders. Twenty of the 106 exhibited celiac symptoms and were prescribed a gluten-free diet.
At 2 years follow-up, 89 of the 106 were on a gluten-containing diet. Thirty-nine underwent a second biopsy, and 23% of them had developed villous atrophy.
At 3 years follow-up, 26 children were still consuming gluten. Six underwent a third biopsy, and 50% of them exhibited villous atrophy.
In total, 30% of children who were re-biopsied showed signs of intestinal damage within 3 years.
Researchers identified potential predictive markers for villous atrophy:
“Only the presence of intestinal deposits in the first biopsy seem to predict the evolution to villous atrophy, in particular patients who did not show deposits had a low probability to develop villous atrophy,” they concluded.
This study is currently in press at Clinical Gastroenterology and Hepatology