Gabriela Leşanu *, Alina Stănescu **, Cristina Becheanu *, Rafira Câtu *
* Dr. Gabriela Leşanu, Dr. Cristina Becheanu, Dr. Rafira Câtu – Spitalul Central de Copii Gr. Alexandrescu
** Dr. Alina Stănescu – Clinica de Pediatrie IOMC “Prof. Alfred Rusescu”
Abstract
The gluten – free diet (GFD) is the cornestone of the management of the coeliac disease (CD) patients. ln a group of 42 patients admitted in the Central Children’s Hospital for CD, we selected 24 children who have been followed-up for at least one year. At the time of admission the median age of the patients was 4,6 years (range, 11 months-13 years). The group had 14 (58,3%) girls and 10 (41,7%) boys. The patients have been followed-up a variable period (range. 1-15 years). 4 (16,6%) children didn’t accept the GDF (from the begining). 2 children maintained the GFD for 6 months and after a year only 18 (75%) patients were adhering to a GDF. 10 coeliac patients have been followed-up more than 2 years. After 3 years only 3 (30%) maintained a strict GDF. After a period of poor dietary compliance some coeliac teenagers began to accept the disease and to understand the importance of the GDF. At present the study of the compliance of the 24 CD patients showed: 2 (8,3%) patients are noncompliant, 6 (25%) patients have a poor compliance and 16 (66,7%) are compliant. The patients with poor compliance or noncompliant were: 1) with clinical symptoms suggestive of CD; 2) with atypical symptoms and nutritional disturbances; 3) asymptomatic but with immunologic features of gluten sensitivity; 4) asymptomatic without serologic markers but with villous atrophy. ln conclusion 1/3 of the CD patients have a poor compliance or they are noncompliant. The patients with poor compliance may be asymptomatic with normal hematologic and biochimic features but with serologic markers and histologic abnormalities. The coeliac patients need considerable support to understand that a GFD is mandatory in order to have a good quality of life.