Enfermedad celíaca en el adolescente y adulto joven: un desafío para gastroenterólogos de niños y adultos / Celiac disease in adolescents and young adults: a follow up study

RESUMO

Background: Follow-up of celiac patients in Chile is often interrupted when adolescents are referred to adult gastroenterologists. Aim: To study the evolution of patients with celiac disease when they reach adolescence or young 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 this assessment was 17.8 ñ 5 years, 65.5 percent were women, 12.5 percent were at nutritional risk (-IDS) while 20 percent were overweight/obese. Although all patients declared themselves asymptomatic, a focused questionnaire revealed that 26 percent suffered some symptoms. Only 24.1 percent followed a strict gluten-free diet. Eight of 20 patients who ate gluten-containing diets had negative antiendomysial antibodies (EMA), three of whom turned positive within 6 to 9 months. In three of four (asymptomatic) cases that accepted a new jejunal biopsy, histology was abnormal. One patient who followed a strict diet had EMA (+) and normal histology. Conclusions: These results confirm that after childhood, symptoms abate significantly in celiac patients. The observed sensitivity and specificity of EMA makes necessary to maintain small intestinal biopsies as the gold standard for diagnosis and confirmation of the disease