Abstract
In young infants the clinical and investigative features of coeliac disease (CD) may be mimicked by other conditions such as cow's milk intolerance or secondary disaccharidase deficiency. It is therefore especially important to confirm a diagnosis of CD by later gluten challenge in such infants. Sixteen children in whom the diagnosis of CD had been made before the age of 12 months had an oral gluten challenge, after being treated with a gluten-free diet for periods of one month to 5 years. In 15 we showed intestinal xylose malabsorption by the one-hour blood xylose level within 1-28 days of starting ingestion of gluten. One child, with a persistently normal one-hour blood xylose test after gluten challenge for 3 months, had normal absorption and normal jejunal histology after 18 months on a gluten-containing diet; she is considered not to have CD. The one-hour blood xylose test before and after gluten challenge can help to confirm the diagnosis in coeliac patients diagnosed in infancy.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson C. M. Intestinal malabsorption in childhood. Arch Dis Child. 1966 Dec;41(220):571–596. doi: 10.1136/adc.41.220.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Arthur A. B., Clayton B. E., Cottom D. G., Seakins J. W., Platt J. W. Importance of disaccharide intolerance in the treatment of coeliac disease. Lancet. 1966 Jan 22;1(7430):172–174. doi: 10.1016/s0140-6736(66)90699-4. [DOI] [PubMed] [Google Scholar]
- Doe W. F., Booth C. C., Brown D. L. Evidence for complement-binding immune complexes in adult coeliac disease, Crohn's disease, and ulcerative colitis. Lancet. 1973 Feb 24;1(7800):402–403. doi: 10.1016/s0140-6736(73)90254-7. [DOI] [PubMed] [Google Scholar]
- Hamilton J. R., McNeill L. K. Childhood celiac disease: response of treated patients to a small uniform daily dose of wheat gluten. J Pediatr. 1972 Nov;81(5):885–893. doi: 10.1016/s0022-3476(72)80538-9. [DOI] [PubMed] [Google Scholar]
- Levine R. A., Briggs G. W., Harding R. S., Nolte L. B. Prolonged gluten administration in normal subjects. N Engl J Med. 1966 May 19;274(20):1109–1114. doi: 10.1056/NEJM196605192742003. [DOI] [PubMed] [Google Scholar]
- Liu H. Y., Tsao M. U., Moore B., Giday Z. Bovine milk protein-induced intestinal malabsorption of lactose and fat in infants. Gastroenterology. 1968 Jan;54(1):27–34. [PubMed] [Google Scholar]
- McNeish A. S., Anderson C. M. Coeliac disease. The disorder in childhood. Clin Gastroenterol. 1974 Jan;3(1):127–144. [PubMed] [Google Scholar]
- McNeish A. S. Diagnosis of coeliac disease in retrospect. Arch Dis Child. 1968 Jun;43(229):362–364. doi: 10.1136/adc.43.229.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McNeish A. S., Sweet E. M. Lactose intolerance in childhood coeliac disease. Assessment of its incidence and importance. Arch Dis Child. 1968 Aug;43(230):433–437. doi: 10.1136/adc.43.230.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rolles C. J., Nutter S., Kendall M. J., Anderson C. M. One-hour blood-xylose screening-test for coeliac disease in infants and young children. Lancet. 1973 Nov 10;2(7837):1043–1045. doi: 10.1016/s0140-6736(73)92656-1. [DOI] [PubMed] [Google Scholar]
- SHELDON W. Celiac disease. Pediatrics. 1959 Jan;23(1 Pt 1):132–145. [PubMed] [Google Scholar]
- Shiner M., Ballard J. Antigen-antibody reactions in jejunal mucosa in childhood coeliac disease after gluten challenge. Lancet. 1972 Jun 3;1(7762):1202–1205. doi: 10.1016/s0140-6736(72)90924-5. [DOI] [PubMed] [Google Scholar]
- Walker-Smith J. Transient gluten intolerance. Arch Dis Child. 1970 Aug;45(242):523–526. doi: 10.1136/adc.45.242.523. [DOI] [PMC free article] [PubMed] [Google Scholar]