ABSTRACT
Strict criteria for the diagnosis of celiac disease are laid down by the European Society for Pediatric Gastroenterology and Nutrition (ESPGAN). Children with a flat mucosa in the small intestine, no other known reason for this condition after extensive studies, and having a clinical remission a few weeks after the introduction of a GFD were considered to have celiac disease. In the course of the prospective study each child with suspected celiac disease underwent jejunal biopsy, irrespective of the outcome of the anti wheat, antigluten, and antigliadin antibodies determination. A morphological relapse of the jejunal mucosa after gluten challenge is proof of persistent gluten intolerance. Most patients with persistent gluten intolerance produce antigliadin antibodies during the challenge period, usually before the mucosa becomes pathologic. In patients with Crohn’s disease the diagnosis was based on the typical endoscopical changes in the colon and the terminal ileum.
