{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T13:36:31Z","timestamp":1765632991164,"version":"3.48.0"},"reference-count":25,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1979,2]]},"abstract":"<jats:p>Fifty children consecutively attending a clinic for coeliac disease co-operated in a trial; 10 found to have flat mucosa were excluded. Forty children of mean age 9.8 years, whose duodenal or jejunal mucosa had returned to normal or near normal appearance after a mean of 5.8 years on gluten-free diets, were put back on normal diets. In 37, mucosal occurred in a mean of 16.9 months (four to 74 months). Four of the 37 had serial biopsies, in which mucosal enzymes (particularly lactase) fell and interepithelial lymphocyte counts rose before the mucosal morphology was regarded as definitely 'coeliac'. Three children had normal mucosal appearance after 58 to 73 months on normal diets, one of whom showed temporary mucosal abnormalities, another having occasionally low enzymes, in both suggesting underlying gluten sensitivity. Lactase suppression and raised IEL counts appear to be sensitive indicators of gluten intolerance. In our experience, a diagnosis of coeliac disease based on severe mucosal damage and a satisfactory response to a gluten-free but milk-containing diet implies a very strong likelihood of permanent or prolonged gluten intolerance, but with a striking variability in its expression.<\/jats:p>","DOI":"10.1136\/gut.20.2.126","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"126-132","source":"Crossref","is-referenced-by-count":23,"title":["Variability of gluten intolerance in treated childhood coeliac disease."],"prefix":"10.1136","volume":"20","author":[{"given":"B","family":"McNicholl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Egan-Mitchell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P F","family":"Fottrell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1979,2,1]]},"reference":[{"key":"ref_1","first-page":"76","article-title":"Morphologic and functional effects of gluten feeding on jejunal mucosa","volume-title":"celiac disease. In Coeliac Disease","author":"Bayless, T.M.; Rubin, S.E.; Topping, T.M.; Yardley, J.H.; Hendrix, T.R.","year":"1970","unstructured":"Bayless, T. M., Rubin, S. E., Topping, T. M., Yardley, J. H., and Hendrix, T. R. (1970). Morphologic and functional effects of gluten feeding on jejunal mucosa in celiac disease. In Coeliac Disease, pp. 76-89. Edited by C. C. Booth and R. H. Dowling. Churchill Livingstone: London."},{"key":"ref_2","article-title":"Assay of intestinal disaccharidases","author":"Dahlqvist, A.","year":"1968","unstructured":"Dahlqvist, A. (1968). Assay of intestinal disaccharidases."},{"key":"ref_3","first-page":"23","article-title":"Coeliac disease. Is there a natural recovery?","volume":"24","author":"Gerrard, J.W.; Ross, C.A.C.; Astley, R.; French, J.M.; Smellie, J.M.","year":"1955","unstructured":"Gerrard, J. W., Ross, C. A. C., Astley, R., French, J. M., and Smellie, J. M. (1955). Coeliac disease. Is there a natural recovery? Quarterly Journal of Medicine, 24, 23-32.","journal-title":"Quarterly Journal of Medicine"},{"key":"ref_4","article-title":"Biological sampling for monitoring population exposure to lead","volume":"121","author":"Orimes, H.","year":"1975","unstructured":"Orimes, H. (1975). Biological sampling for monitoring population exposure to lead. Galway Medical Annual, Special Edition, 121.","journal-title":"Galway Medical Annual, Special Edition"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/S0022-3476(72)80538-9","article-title":"Childhood celiac disease; response of treated patients to a small uniform daily dose of wheat gluten","volume":"81","author":"Hamilton, J.R.; McNeill, L.K.","year":"1972","unstructured":"Hamilton, J. R., and McNeill, L. K. (1972). Childhood celiac disease; response of treated patients to a small uniform daily dose of wheat gluten. Journal of Pediatrics, 81, 885-893.","journal-title":"Journal of Pediatrics"},{"key":"ref_6","first-page":"849","article-title":"Effets precoce de la reintroduction du gluten sur la muqueuse intestinale dans la maladie coeliaque en remission","volume":"26","author":"Jos, J.; Rey, J.; Frezal, J.","year":"1969","unstructured":"Jos, J., Rey, J., and Frezal, J. (1969). Effets precoce de la reintroduction du gluten sur la muqueuse intestinale dans la maladie coeliaque en remission. Archives Francaises de Pediatrie, 26, 849-859.","journal-title":"Archives Francaises de Pediatrie"},{"key":"ref_7","first-page":"33","article-title":"A microtechnique for the assay of intestinal alkaline phosphatase","volume":"3","author":"Kelly, M.H.; Hamilton, J.R.","year":"1970","unstructured":"Kelly, M. H., and Hamilton, J. R. (1970). A microtechnique for the assay of intestinal alkaline phosphatase. Clinics in Biochemistry, 3, 33-43.","journal-title":"Clinics in Biochemistry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S0021-9258(19)52451-6","article-title":"Protein measurement with the folin phenol reagent","volume":"193","year":"1951","unstructured":"Lowry, 0. H., Rosebrough, A. J., Farr, A. L., and Randall, R. J. (1951). Protein measurement with the folin phenol reagent. Journal of Biological Chemistry, 193, 265-275.","journal-title":"Journal of Biological Chemistry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/000992286800700910","article-title":"Jejunal biopsy in celiac disease","volume":"7","author":"McNicholl, B.; Egan, B.","year":"1968","unstructured":"McNicholl, B., and Egan, B. (1968). Jejunal biopsy in celiac disease. Clinical Pediatrics, 7, 544-552.","journal-title":"Clinical Pediatrics"},{"key":"ref_10","first-page":"418","article-title":"Mucosal recovery in treated childhood celiac disease","volume":"89","author":"McNicholl, B.; Egan-Mitchell, B.; Stevens, F.; Keane, R.; Baker, S.; McCarthy, C.F.; Fottrell, P.F.","year":"1976","unstructured":"McNicholl, B., Egan-Mitchell, B., Stevens, F., Keane, R., Baker, S., McCarthy, C. F., and Fottrell, P. F. (1976). Mucosal recovery in treated childhood celiac disease. Journal ofPediatrics, 89, 418-424.","journal-title":"Journal ofPediatrics"},{"key":"ref_11","first-page":"413","article-title":"Varying gluten susceptibility in coeliac disease","volume-title":"Coeliac Disease","author":"McNicholl, B.; Egan-Mitchell, B.; Fottrell, P.F.","year":"1974","unstructured":"McNicholl, B., Egan-Mitchell, B., and Fottrell, P. F. (1974). Varying gluten susceptibility in coeliac disease. In Coeliac Disease, pp. 413-418. Edited by W. T. J. M. Hekkens and A. S. Pefia. Stenfert Kroese: Leiden."},{"key":"ref_12","first-page":"461","article-title":"Diagnostic criteria in coeliac disease: Round Table Discussion of the European Society for Paediatric Gastroenterology","volume":"59","author":"Meeuwisse, G.W.","year":"1970","unstructured":"Meeuwisse, G. W. (1970). Diagnostic criteria in coeliac disease: Round Table Discussion of the European Society for Paediatric Gastroenterology. Acta Paediatrica Scandinavica, 59, 461-463.","journal-title":"Acta Paediatrica Scandinavica"},{"key":"ref_13","first-page":"359","article-title":"Family studies in coeliac disease","volume":"43","author":"Mylotte, M.; Egan-Mitchell, B.; Fottrell, P.F.; McNicholl, B.; McCarthy, C.F.","year":"1974","unstructured":"Mylotte, M., Egan-Mitchell, B., Fottrell, P. F., McNicholl, B., and McCarthy, C. F. (1974). Family studies in coeliac disease. Quarterly Journal of Medicine, New Series, 43, 359-369.","journal-title":"Quarterly Journal of Medicine, New Series"},{"key":"ref_14","first-page":"457","article-title":"Disaccharidase activity and jejunal morphology in coeliac disease","volume":"41","author":"Pefia, A.S.; Truelove, S.C.; Whitehead, R.","year":"1972","unstructured":"Pefia, A. S., Truelove, S. C., and Whitehead, R. (1972). Disaccharidase activity and jejunal morphology in coeliac disease. Quarterly Journal of Medicine New Series, 41, 457-476.","journal-title":"Quarterly Journal of Medicine New Series"},{"key":"ref_15","first-page":"621","article-title":"Studies of celiac sprue, III. The effect of repeated wheat instillation into the proximal ileum of patients on a gluten-free diet","volume":"43","author":"Rubin, C.E.; Brandberg, L.L.; Flick, A.L.; Phelps, P.; Parmentier, C.; Van Niel, S.","year":"1962","unstructured":"Rubin, C. E., Brandberg, L. L., Flick, A. L., Phelps, P., Parmentier, C., and Van Niel, S. (1962). Studies of celiac sprue, III. The effect of repeated wheat instillation into the proximal ileum of patients on a gluten-free diet. Gastroenterology, 43, 621-641.","journal-title":"Gastroenterology"},{"year":"1975","author":"Rolles, C.J.; Anderson, C.M.; McNeish, A.S.","key":"ref_16","unstructured":"Rolles, C. J., Anderson, C. M., and McNeish, A. S. (1975)."},{"key":"ref_17","first-page":"579","article-title":"Clinical and morphologic changes following gluten administration to patients with treated celiac disease","volume":"52","author":"Schenk, E.A.; Samloff, I.M.","year":"1968","unstructured":"Schenk, E. A., and Samloff, I. M. (1968). Clinical and morphologic changes following gluten administration to patients with treated celiac disease. American Journal of Pathology, 52, 579-585.","journal-title":"American Journal of Pathology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/bmj.2.5654.401","article-title":"Prognosis in early adult life of coeliac children treated with a gluten-free diet","volume":"2","author":"Sheldon, W.","year":"1969","unstructured":"Sheldon, W. (1969). Prognosis in early adult life of coeliac children treated with a gluten-free diet. British Medical Journal, 2, 401-404.","journal-title":"British Medical Journal"},{"key":"ref_19","first-page":"311","article-title":"An analysis of controlled relapses in gluten induced coeliac disease (Abstract)","volume":"58","author":"Shmerling, D.H.","year":"1969","unstructured":"Shmerling, D. H. (1969). An analysis of controlled relapses in gluten induced coeliac disease (Abstract). Acta Paediatrica Scandinavica, 58, 311.","journal-title":"Acta Paediatrica Scandinavica"},{"key":"ref_20","first-page":"64","volume-title":"The response of the intestinal mucosa to the intraduodenal instillation of gluten in patients with coeliac disease during remission: In Coeliac Disease","author":"Booth, C.C.; Shmerling, D.H.; Shiner, M.","year":"1970","unstructured":"Shmerling, D. H., and Shiner, M. (1970). The response of the intestinal mucosa to the intraduodenal instillation of gluten in patients with coeliac disease during remission: In Coeliac Disease, pp. 64-74. Edited by C. C. Booth and R. H. Dowling. Churchill Livingstone: London."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1016\/S0140-6736(59)91556-9","article-title":"Standards for height and weight of British children from birth to maturity (Letter)","volume":"2","author":"Tanner, J.M.; Whitehouse, R.H.","year":"1959","unstructured":"Tanner, J. M., and Whitehouse, R. H. (1959). Standards for height and weight of British children from birth to maturity (Letter). Lancet, 2, 1086.","journal-title":"Lancet"},{"year":"1970","author":"Visakorpi, J.K.; Kuitunen, P.; Savilahti, E.","key":"ref_22","unstructured":"Visakorpi, J. K., Kuitunen, P., and Savilahti, E. (1970)."},{"key":"ref_23","article-title":"Transient gluten intolerance","author":"Walker-Smith, J.","year":"1970","unstructured":"Walker-Smith, J. (1970). Transient gluten intolerance."},{"key":"ref_24","first-page":"361","article-title":"Dermatitis herpetiformis and celiac sprue","volume-title":"Coeliac Disease","author":"Weinstein, W.M.; Piercy, J.R.A.; Dossetor, J.B.","year":"1974","unstructured":"Weinstein, W. M., Piercy, J. R. A., and Dossetor, J. B. (1974). Dermatitis herpetiformis and celiac sprue. In Coeliac Disease, pp. 361-369. Edited by W. T. J. M. Hekkens and A. S. Pefia. Stenfert Kroese: Leiden."},{"key":"ref_25","article-title":"110 children with coeliac disease, 1950-1969. Archives ofDisease in Childhood","author":"Young, W.F.; Pringle, E.M.","year":"1971","unstructured":"Young, W. F., and Pringle, E. M. (1971). 110 children with coeliac disease, 1950-1969. Archives ofDisease in Childhood."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.20.2.126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T13:33:16Z","timestamp":1765632796000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.20.2.126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1979,2]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1979,2,1]]},"published-print":{"date-parts":[[1979,2]]}},"alternative-id":["10.1136\/gut.20.2.126"],"URL":"https:\/\/doi.org\/10.1136\/gut.20.2.126","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1979,2]]}}}