I have found lots of new research regarding Celiac disease and kids. I’m going to talk about a new testing method and a 12-year study regarding the risks of developing Celiac – with an 80% accuracy of forecasting kids that will develop Celiac.
First up, a new testing method for children with the disease. It involves a breath test. Research suggests that DPP4 enzyme is involved in breaking down gluten. People with Celiac disease have reduced amounts of DPP4 in the small intestine. This new breath test measures the amount of DPP4. It implies a simple, non-invasive way to test for Celiac. Trials are about to begin. I don’t have information about where the trials will take place yet. I will keep looking for this one.
Second, a twelve year study of children with potential Celiac disease predict the number of children that will eventually develop Celiac. The study involved 280 children between 2 and 18 with potential Celiac over the course of 12 years. Potential Celiac in this situation means two consecutive positive results on anti-Tg2, postive EMA, normal villious architecture (Marsh 0 or 1) in 5 biopsies and positive genetic markers (DQ2 or DQ8). These children did not start a gluten free diet immediately.
Villious atrophy is the hallmark of Celiac disease. It means that the small finger like projections that absorb food in the small intestine have been shortened or blunted. This damage is rated on a Marsh scale. Marsh 0-1 indicate increased white blood cells – intraepithelial lymphycytes but no damage to the villi. Marsh 2 is unusual and typically only found with Dermititis Herpitformis. Marsh 3 or higher indicates damage to the villi and Celiac disease.
As reported in Gastroenerology, the follow up is interesting. Forty- two or 15% of the children developed villious atrophy during the follow up period, but a total of 43% of the children progressed to villious atrophy at 12 years. Eight-nine or 32% of children no longer had positive blood tests.
Of the children that developed villious atrophy, they noted a strong association with the numbers of gamma delta intraepithelial lymphocytes, age at diagnosis, and two copies of DQ2. In looking at these factors, they were able to predict 80% of the children that would progress to villious atrophy.
They said the genetics was an important risk factor for children in the 3 to 10 year range, but the risk factor from genetics lost its significance after 10. Gender and a family history of autoimmunity did not affect risk.
So, now, they can almost predict children that will progress to Celiac disease when doing blood tests and upper endoscopy with biopsies. This is important for parents because it has to be exceptionally difficult to see your child suffer without a clear diagnosis.
Finally, I know that watching a child struggle with being ill and then struggling to fit in with this diagnosis has to got to be challenging. Keep up the fight and you are doing the right thing!
Predicting Celiac in children with positive blood tests and negative biopsy article.