[Results of small intestinal biopsy studies in childhood and their correlation to other paraclinical findings with special reference to celiac disease].

Abstract

From 1970 to 1983 1,000 successful peroral intestinal biopsies were carried out at the children's Hospital of the Medical Academy Dresden. No complications such as perforation or bleeding appeared. Peroral intestinal biopsy has a preeminent importance in the diagnostic of coeliac disease. Certain paraclinical parameters in children with coeliac disease were correlated with bioptically recordable small intestinal mucosa changes; from which following results and conclusions can be drawn: Neither reticulin nor gluten antibodies can be recommended as screening parameters for the peroral intestinal biopsy. The determination of reticulin antibodies is better suited for diet checking because of its greater specificity . During the acute phase of coeliac disease 50 per cent of the cases are to be expected to have decreased serum zinc levels. A short-term zinc substitution is to be recommended. An increased number of pathological EEG's can be found in children with coeliac disease; particularly after a longterm gluten-containing diet. Therefore gluten-provocation to diagnose a coeliac disease should be performed after the 6th year of life, this is after completion of the cerebral cell differentiation.