Abstract
Altogether 31 postpubertal children 15 to 22 years old with established CD were rebiopsied. 10 had mucosal abnormality indicating poor adherence to the diet. Normal gluten containing diet was reintroduced in 21 patients who had normal mucosa and were negative for ARA. The patients were retested for ARA every 3 months. IgA-ARA turned positive (≥1:50) within 3 to 24 months (mean 8 months) in 17 patients before (12) or at the same time with abdominal symptoms (5). Histologically a clear relapse of CD was seen in all cases. One patient developed major abdominal symptoms at 4 months. Her ARA were negative and small bowel mucosa showed slight changes. Three patients had no symptoms and a negative ARA test at 24 months. The mucosa was normal in two and flat in one. Thus the possible recovery of CD was 2/31 or 6.5 %. We conclude that IgA-ARA can in most cases be used to determine the time of rebiopsy during gluten challenge before any symptoms occur. To establish definite recovery of CD in cases with normal mucosa at 2 years of challenge, further follow up studies of ARA and later rebiopsy are needed.
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