Undiagnosed coeliac disease at age seven: population based prospective birth cohort study

Coeliac disease is surely underdiagnosed even in childhood and it could depend by the variety of its clinical features. Moreover patients could have many problembs in the case of a slight simptomatology and isto- pathological findings. In two cases, mother and son, cause of their lwo stature and abdominal symptoms coaliac disease was suspected. IgA-EMA were found positive in both the patients. Mucosal findings at Duodenal biopsies did not show the coeliac classic alterations: it was only slightly flat and so it was defined by the pathologist not sure for diagnosing coeliac disease. The patients by themselves started a gluten free diet and it was observed a rapid improvement of their symptoms. IgA-EMA were non controlled again couse the time of diet was too short. In fact after few months they stopped the diet because of the cost. In Italy gluten free foods are fee-free only in those cases were mucosal changes are strong: flat mucosa. EMA and AGA antibodies are just used for the follow up. So what will these patient do? and what shall we, as gps or specialists, do in tese cases? Is it the case to reclisify this disease? Let's try to answer if Coeliac Disease: one or more types?(1)

(1)Coeliac Disease: one or more types? BMJ;4 December 2003

Competing interests: None declared