Coeliac disease: a histological follow-up study
Article first published online: 28 FEB 2007
Volume 50, Issue 4, pages 465–471, March 2007
How to Cite
Bardella, M. T., Velio, P., Cesana, B. M., Prampolini, L., Casella, G., Di Bella, C., Lanzini, A., Gambarotti, M., Bassotti, G. and Villanacci, V. (2007), Coeliac disease: a histological follow-up study. Histopathology, 50: 465–471. doi: 10.1111/j.1365-2559.2007.02621.x
- Issue published online: 28 FEB 2007
- Article first published online: 28 FEB 2007
- Date of submission 26 January 2006 Accepted for publication 10 May 2006
- coeliac disease;
- gluten-free diet;
Aims: To assess the histological response to a gluten-free diet (GFD) in a series of coeliac patients in clinical remission, of different ages and with varying degrees of mucosal damage at diagnosis.
Methods and results: Biopsy samples from 249 coeliac patients (F 165, M 84) were analysed basally and after clinical and biochemical remission following a GFD. All patients showed an improvement in mucosal findings after starting a GFD, but complete histological normalization was observed in 74.1% of paediatric cases (diagnosed before 14 years of age) and in only 17.5% of adults. Statistical analysis showed that sex, the clinical picture at diagnosis and the length of time between biopsy at the time of diagnosis and on a GFD were not related to histological normalization. In contrast, the age at diagnosis was statistically significantly related to it (P < 0.0001). In addition, the presence/absence of Helicobacter pylori was independent of the normalization of the duodenal mucosa.
Conclusions: In clinical practice the criteria for diagnosis of coeliac disease are sufficiently standardized, whereas for follow-up they are less well defined. We suggest that in order to compare the results from different studies, it should be stated whether remission after treatment is based on clinical or histological criteria or both.