Negative results of antiendomysial antibodies: long term follow up.

Fifteen patients with intestinal villous atrophy, but simultaneously negative results of antiendomysial antibodies (EMA) were studied. Two patients were finally diagnosed as having coeliac disease. The predictive value of negative results of EMA assessment in children suspected of coeliac disease is high, approaching 86.7%.

Ultrasound picture of gastroesophageal junction in children with reflux disease.

The assessment of gastroesophageal junction morphology is very important in children with reflux disease. Authors present ultrasonographic measurements of subdiaphragmatic part of the esophagus and His angle. In children with reflux disease, marked shortening of subdiaphragmatic part of esophagus and completely obtuse His angle were found. Ultrasound imaging of gastroesophageal junction is valuable part of ultrasound diagnostics of reflux and may be helpful in establishing the etiology and choosing the treatment method.

Transmission electron microscopy of microvilli of intestinal epithelial cells in celiac disease in remission and transient gluten enteropathy in children after a gluten-free diet.

The structure of microvilli of intestinal epithelial cells was investigated in 70 children: 34 with celiac disease in remission, 28 with transient gluten enteropathy after a gluten-free diet, and eight controls. Transmission electron microscopy was used to determine the mean thickness of the glycocalyx layer covering the microvilli, the mean length and width of microvilli, and the number of microvilli per 1 micron length of enterocyte surface. The structure of the glycocalyx was found to be intact, but in some children with treated celiac disease the layer of glycocalyx was either thin or absent on the surface of individual cell microvilli. In children with treated celiac disease, microvilli were statistically significantly shorter than those in children with transient gluten enteropathy and controls. Microvillous width in treated celiac disease was greater as compared with that in controls. There was no difference in the number of microvilli on the enterocyte surface in the three groups.

[Morphologic appearance of intestinal microvilli in children with coeliac disease and secondary malabsorption syndromes after gluten-free diet and gluten challenge]. / Obraz morfologiczny mikrokosmków jelitowych u dzieci z celiakia i wtórnymi zespolami zaburzen wchlaniania po diecie bezglutenowej i prowokacji glutenem.

The glycocalyx and the structure of the microvilli were analysed in electron microscopy in 122 children with coeliac disease and secondary syndromes of malabsorption. Slight differences were noted in glycolayx structure between both groups of children. In children with coeliac disease its reduction was noted (after gluten challenge). Changes were observed also in the structure of the microvilli. They were lower and often with abnormal shape in coeliac disease, while they were high and of normal structure in secondary malabsorption syndromes.

[Serum triiodothyronine and thyroxine levels in children with celiac disease]. / Stezenie trijodotyroniny i tyroksyny w surowicy u dzieci chorych na celiakie.

The study was aimed at determining relationship between thyroid function and the type and degree of malabsorption. Serum triiodothyronine (T3) and thyroxine (T4) levels were determined in children with celiac disease and the secondary malabsorption. Hundred fifty five children aged between 6 months and 7 years were followed up 3 years. Coeliac disease was diagnosed with classic Interlaken criteria. All children were divided into three groups: group I--57 children aged between 6 months and 3 years with suspected celiac disease; group II--55 children aged between 2.5 and 6 years after gluten-free diet therapy; group III--52 children aged between 3 and 7 years after gluten provocation test. Serum T3 and T4 levels for each group were compared with those in children with normal gut mucous membrane. Blood serum T3 and T4 were assayed with OPIDI kit (manufactured in Swierk). Serum T4 levels were significantly lower in children with mucous membrane atrophy in comparison with dystrophic children and normal gut mucous membrane. Both serum T3 and T4 were significantly lowered in the youngest children upto 12 months of life with mucous membranes atrophy. Serum T3 and T4 concentrations were below the normal values in 4 youngest children. Blood serum T3 and T4 levels did not depend on the morphology of the intestinal villi in children treated with gluten-free diet (some children did not observe the diet and had atrophic lesions to the mucous membrane of the small intestine). Blood serum T3 level was relatively increased in children of group II with mucous membrane regeneration; in comparison with the value determined in the period of active disease.