Celiac disease in adolescents and young adults. A follow-up study

Background: Follow-tip of celiac patients in Chile is often interrupted whe n adolescents are referred to adult gastroenterologists. Aim: To study the evolution of patients with celiac disease when they reach adolescence or yo ung adulthood. Patients and methods: Current adherence to gluten-free diet and its relation to symptoms and circulating antiendomysial antibodies were , evaluated in the 58 confirmed celiac patients older than 12 years of age controlled at 3 hospitals in Santiago. Results: Mean age at the moment of t his assessment was 17.8 +/- 5 years, 65.5% were women, 12.5% were at nutrit ional risk (-IDS) while 20% were overweight/obese. Although all patients de clared themselves asymptomatic, a focused questionnaire revealed that 26% s uffered some symptoms. Only 24.1% followed a strict gluten-free diet. fight of 20 patients who ate gluten-containing diets had negative antiendomysial antibodies (EMA), three of whom turned positive within 6 to 9 months, in t hree of four (asymptomatic) cases that accepted a new jejunal biopsy, histo logy was abnormal. One patient who followed a strict diet bad EMA (+) and n ormal histology, Conclusions: These results confirm. that after childhood, symptoms abate significantly in celiac patients. The observed sensitivity a nd specificity of EMA makes necessary to maintain small intestinal biopsies as the gold standard for diagnosis and confirmation of the disease. (Rev M id Chile 2001; 743-8).