NEED FOR FOLLOW-UP IN CELIAC-DISEASE

The use of follow up studies was evaluated in 128 patients with coelia c disease during their first visit to a department for adults. The ori ginal diagnosis had been made in childhood in all patients. Fifty eigh t (45%) of the subjects were following a gluten free diet, 23 (18%) we re following a gluten free diet but with occasional gluten consumption , and 47 (37%) had adopted an unrestricted, gluten containing diet for a mean of 11.2 years. There was no correlation in individual subjects between the presence of symptoms, biochemical and immunological abnor malities, severity of histological findings, and the amount of dietary gluten, despite the greater frequency of symptoms in the group follow ing an unrestricted diet than in the other two groups. Short stature a nd epilepsy with cerebral calcifications only occurred in patients fol lowing an unrestricted diet. As only diagnosis based on two or three b iopsy samples and regular follow up correlated positively with dietary compliance, it is suggested that a histologically confirmed diagnosis of coeliac disease and regular lifelong follow up are essential in th e management of these patients.