Dynamics of physical development in neglected celiac disease
Radzikowski, A.; Kulus, M.; Zalewski, T.
Pediatria Polska 62(5): 310-322
1987
ISSN/ISBN: 0031-3939 PMID: 3670921 Document Number: 300338
The rate of growth and weight gain was analysed in 47 children aged over 3 years with coeliac disease at the time of villous atrophy (gluten-dependent enteropathy) in which the syndrome of malabsorption had been diagnosed before the age of 3 years. On the basis of interviews with parents gluten-free diet was given during 15 months, on average. Then arbitrarily the usual diet containing gluten was given which caused histological recurrence in all 47 children. They were examined periodically, with determinations of body weight and length, and persistence of atrophy of duodenal villi was found in them. On the basis of an analysis of 47 individual curves of body weight and height collective curves were plotted for the age from 1 to 9 years, separately for boys and girls with gluten-dependent enteropathy and were transferred into percentile papers for Warsaw children. The curves were analysed of height and weight plotted for girls and boys collectively, based on standardized measurements. Up to the age of 3 years the rates of weight gain and growth were typical for coeliac disease treated with gluten-free diet. Between the age of 3 and 9 years at the time of return to gluten-containing diet in girls with gluten-dependent enteropathy the growth curve oscillated between 10 and 25 centiles, and the curve of body weight was along the 25 centile up to the age of 7 years, and along the 15 centile between the ages of 7 and 9 years. In boys in the same period the growth curve was along the 10 centile, and the weight curve oscillated between 10 and 25 centiles. Thus in both sexes the height curves were at a lower centile level than the body weight curves. The mutual courses of curves were analysed on the basis of standardized measurements. Past the age of 3 years the height curve was at a mean level (-1), and the weight curve at the (-0.8) level. This indicates a primary character of height disturbances and secondary character of weight deficiency in relation to normal. The impairment of growth observed by the authors with gluten-dependent enteropathy is yet another argument for a continuous treatment with gluten-free diet during many years in children with coeliac disease.