dr Mridul Chandra Das
Pediatric Gastroenterologist
Centre for Child Health, BLK Super Speciality Hospital
About Author

Potential celiac disease refers to patients who are diagnosed with gluten sensitivity by a positive tTG-IgA or endomysial antibody but who have a normal small bowel biopsy. For these patients, management decisions are based on the presence of symptoms. For children who are truly asymptomatic, a gluten-free diet is not recommended.

Because a child may not effectively communicate about symptoms that may herald active disease, periodic re-evaluation for symptoms and appropriate growth is important. An additional endoscopy with re-biopsy should be performed when appropriate in high-risk patients (eg, those who develop gastrointestinal symptoms and/or have rising titers of celiac serologic tests).

Before considering a patient to have potential celiac disease, it is important to repeat the antibody testing and to make certain that the intestinal biopsies were adequate. In addition, further serologic testing using a second specific antibody (eg, anti-endomysial IgA antibodies)is recommended. HLA testing may also be helpful; if the patient has neither the DQ2 nor DQ8 genotype, the likelihood of having celiac disease is extremely low.



Posted On: 22/07/2019

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