潜在乳糜泻(PCD)是以存在阳性CD特异性血清学和正常肠道结构为特征的临床病症。通常建议无症状的PCD患者继续服用含麸质饮食(GCD),但是这种方法的长期风险从未被探索过。在本研究中,我们旨在调查GCD无症状PCD儿童队列中可能出现的营养和自身免疫并发症。我们比较了儿童的生长参数,营养状况,从诊断到最后一次体检之间的自身免疫,长期含麸质饮食后。总之,我们收集了171名PCD儿童的数据,平均随访时间为3年(范围为0.35~15.3年).随访期间,尽管患者并没有减少他们每天的麸质摄入量,他们的抗组织转谷氨酰胺酶(抗TG2)抗体自发且显着降低。大多数分析参数在随访期间没有变化(身高百分位数,铁蛋白,白蛋白,胆固醇,钙,碱性磷酸酶,甲状旁腺激素,和维生素D)或甚至显着改善(体重和BMI百分位数,血红蛋白,血铁,HDL,血糖,和HbA1C,p<0.05),总是保持在正常的限度内。同样,其他伴随的自身免疫性疾病的自身抗体没有随时间增加.从分析中排除停止产生抗TG2的患者和随访时间<3年的患者,获得了类似的结果。我们的初步研究为无症状PCD儿童维持含麸质饮食提供了令人放心的结果,即使考虑了长期随访。
Potential celiac disease (PCD) is a clinical condition characterised by the presence of a positive CD-specific serology and a normal intestinal architecture. Asymptomatic PCD patients are generally advised to continue on a gluten-containing diet (GCD), but long-term risks of this approach have never been explored. In the present study, we aimed to investigate nutritional and autoimmune complications possibly developing overtime in a cohort of asymptomatic PCD children on a GCD. We compared children\'s parameters of growth, nutritional status, and autoimmunity between the time of diagnosis and on the occasion of their last medical check, after a long-term gluten-containing diet. Altogether, we collected data from 171 PCD children with a mean follow-up time of 3 years (range 0.35-15.3 years). During follow-up, although patients did not reduce their amount of daily gluten intake, their anti-tissue transglutaminase (anti-TG2) antibodies spontaneously and significantly decreased. Most parameters analysed had not changed during follow-up (height centile, ferritin, albumin, cholesterol, calcium, alkaline phosphatase, parathormone, and vitamin D) or even improved significantly (weight and BMI centile, haemoglobin, blood iron, HDL, glycaemia, and HbA1C, p < 0.05), always remaining within the limit of normality. Equally, autoantibodies for other concomitant autoimmune disorders did not increase overtime. Similar results were obtained excluding from analysis patients who had stopped producing anti-TG2 and those with a follow-up time < 3 years. Our pilot study has provided reassuring results regarding the maintenance of a gluten-containing diet in asymptomatic PCD children, even when long-term follow-up was considered.