The Spectrum of Gluten Intolerance in a Defined Paediatric Population

Abstract

Over a period of nine years from a population of 32.950 children under fifteen, thirty-two children responded to a gluten free diet. Almost all children underwent jejunal biopsy before being put on the gluten free diet. Two children moved into the area on gluten free diets already with the diagnosis made elsewhere. Reviewing the clinical and biopsy changes of the remaining thrirty, the children fall into three groups. The first group (6) comprises children who fit the description of classical coeliac disease with subtotal or partial villous atrophy and a characteristic history. The second group (18) comprises children with what is usually known as wheat intolerance with minimal biopsy change, rapid reactions to wheat, and often other food atopic reactions. A third group (6) consists of children with minimal biopsy change and deceptive histories. It is possible that this group would become more classical coeliacs with further exposure to gluten. The different biopsy features of the three groups are reviewed.