The findings were based on an analysis of 103 children with coeliac disease who had followed a gluten-free diet for at least a year. Repeat biopsies found persistent intestinal damage in 19% of them.
“The number of children who don't heal on the gluten-free diet was much higher than what I expected," said Dr Alessio Fasano, director of the MGHfC centre and co-senior author of the study.
“We assumed that healing would occur once a patient was put on the gluten-free diet. Now that we have learned that this is not the case for all coeliac patients.”
Similar results have been observed in adults and place both groups at an increased risk of lymphoma, low bone density and fracture.
The research team also commented that the malabsorption and inflammation in children may have negative repercussions on physical and cognitive development.
Researchers from the Mass General Hospital for Children (MGHfC) and Boston Children's Hospital (BCH) reviewed medical histories of these children, who had an average age of 10.6 years at the time of diagnosis.
The children, 60% of which were girls, also underwent a repeat endoscopy with duodenal biopsy at least 12 months after starting a gluten-free diet.
In 2014, a research team from the University of Nottingham found a fourfold increase in the diagnosis of coeliac disease in the UK since the 1990s.
While a gut biopsy is the only definitive way to test for coeliac disease, consumers often choose to self-diagnose, eliminating wheat products for a period of time to see if their health improves.
Food makers have responded with products free of gluten becoming a staple on supermarket shelves.
The gluten-free baby food market in particular is booming as a result of this precautionary approach.
Source: Journal of Pediatric Gastroenterology and Nutrition
Published online ahead of print, DOI : 10.1097/MPG.0000000000001460
“Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet.”
Authors: M. Leonard, D. Weir, M. DeGroote, P. Mitchell, P. Singh, J. Silvester, A. Leichtner, A. Fasano