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Multicenter Study
. 2025 Mar 14;120(7):1657-1661.
doi: 10.14309/ajg.0000000000003400.

Assessing Mucosal Recovery During the First 15 Months of Adopting a Gluten-Free Diet in Children With Celiac Disease

Denis Chang  1   2 , Madison Wong  1   2 , Cleo R Davidowitz  1   3 , Imad Absah  4 , Vahe Badalyan  5 , Mohammad K Chaaban  4 , Lisa Fahey  6 , Daniela M Isaac  7 , Maya Khanna  6 , Marihan Lansing  7 , Edwin Liu  8 , Catherine Raber  5 , Arunjot Singh  6 , Marisa G Stahl  8 , Catharine M Walsh  9 , Jocelyn A Silvester  1   2 , Maureen M Leonard  1   3
Affiliations
Multicenter Study

Assessing Mucosal Recovery During the First 15 Months of Adopting a Gluten-Free Diet in Children With Celiac Disease

Denis Chang et al. Am J Gastroenterol. .

Abstract

Introduction: Determine contemporary rates of early mucosal recovery in children with celiac disease (CeD).

Methods: Multicenter retrospective cohort study in Canada and the United States. Children diagnosed with CeD between 2016 and 2021 who underwent a follow-up biopsy within 15 months of diagnosis were included.

Results: Overall, 96 of 130 children (74%) had mucosal recovery, including 48% children (12/25) who were assessed within 3 months. Musculoskeletal symptoms at diagnosis were the only clinical characteristic associated with persistent enteropathy.

Discussion: While mucosal recovery can occur within months, more than a quarter of children with CeD had persistent enteropathy within 15 months of treatment.

Keywords: celiac disease; enteropathy; gluten-free diet; mucosal recovery; pediatric.

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Conflict of interest statement

Guarantor of the article: Denis Chang, MD.

Specific author contributions: D.C., J.A.S., M.M.L.: planning and/or conducting the study. D.C., M.W., C.R.D., I.A., V.B., M.K.C., L.F., D.M.I., M.K., M.L., E.L., C.R., A.S., M.G.S., C.M.W., J.A.S., M.M.L.: collecting and/or interpreting data. D.C., J.A.S., M.M.L.: drafting the manuscript. All authors approved the final draft that is being submitted.

Financial support: This study was supported by an Investigator Initiated Research grant from Takeda Development Center America's (TDCA), a wholly owned subsidiary of Takeda Pharmaceutical Company Limited (IISR-2023-200393). Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number K23DK122127 (M.M.L.) and K23DK119584 (J.A.S.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Potential competing interests: M.M.L.: reported receiving research support from Takeda Pharmaceuticals and Moderna Inc. E.L.: reported acting as a consultant for Takeda. J.A.S.: reported acting as a consultant for Chugai Pharmaceutical Co. and Takeda Pharmaceuticals and receiving research support from Glutenostics and Takeda Pharmaceuticals. M.G.S.: reported acting as a consultant for Takeda Pharmaceuticals and serves in the DSMB for Pfizer. No other disclosures to report.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Histologic findings on follow-up biopsy.
Figure 2.
Figure 2.
Time from celiac diagnosis and frequency of mucosal recovery on a gluten-free diet.
See this image and copyright information in PMC

References

    1. Mearin ML, Agardh D, Antunes H, et al. ESPGHAN position paper on management and follow-up of children and adolescents with celiac disease. J Pediatr Gastroenterol Nutr 2022;75(3):369–86. - PubMed
    1. Silvester JA, Kurada S, Szwajcer A, et al. Tests for serum transglutaminase and endomysial antibodies do not detect most patients with celiac disease and persistent villous atrophy on gluten-free diets: A meta-analysis. Gastroenterology 2017;153(3):689–701.e1. - PMC - PubMed
    1. Leonard MM, Weir DC, DeGroote M, et al. Value of IgA tTG in predicting mucosal recovery in children with celiac disease on a gluten-free diet. J Pediatr Gastroenterol Nutr 2017;64(2):286–91. - PMC - PubMed
    1. Ghazzawi Y, Rubio-Tapia A, Murray JA, et al. Mucosal healing in children with treated celiac disease. J Pediatr Gastroenterol Nutr 2014;59(2):229–31. - PubMed
    1. Vécsei E, Steinwendner S, Kogler H, et al. Follow-up of pediatric celiac disease: Value of antibodies in predicting mucosal healing, a prospective cohort study. BMC Gastroenterol 2014;14:28. - PMC - PubMed

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