Donatella Iorfida

Autoimmune enteropathy in a 13-year-old celiac girl successfully treated with infliximab.

Autoimmune enteropathy (AIE) is a rare cause of small bowel villous atrophy, characterized by malabsorption, unresponsiveness to dietary restriction, circulating autoantibodies to enterocytes, and an overall predisposition to autoimmunity. Albeit mainly regarded as a disease of early childhood, several adult-onset AIE cases have been identified. This report describes for the first time the life-threatening clinical presentation and the management of overlapping AIE in a compliant-to-diet young celiac girl. A 13-year-old celiac girl was admitted because of vomiting, weight loss, diarrhea, hypoproteinemia, and neurological disturbances such as head tremors, vertical nystagmus, and lower limb hyperesthesia. Before this, she had always been compliant on a strict gluten-free diet and her medical history was unremarkable. The diagnosis of AIE was established on histologic findings and on the presence of antienterocyte antibodies. She was initially treated with high-dose Methylprednisolone and Azathioprine. However, only Infliximab proved itself as a highly effective tool for achieving clinical remission and restoring small bowel villous architecture.

Cereal Consumption among Subjects with Celiac Disease: A Snapshot for Nutritional Considerations

Background: To our knowledge no study has focused on the pattern of cereal-based products (CBP) consumption among people with celiac disease (CD). Our study aimed at evaluating the dietary intake of CBP among patients with CD and comparing it with a control population. Methods: Eighty-two volunteers with CD and 77 non-CD volunteers enrolled throughout Italy were asked to register their consumption of CBP on specific diaries for three days. Results: CD patients’ median three-day intake of biscuits and crackers was higher compared to controls (65.8 g vs. 22.7 g and 44.7 g vs. 10.6 g, p < 0.05 respectively, Mann–Whitney test). A significant difference was observed also comparing the two groups for median three-day bread consumption, with the CD group consuming less bread than controls (109.5 g vs. 150.7 g, p < 0.05, Mann–Whitney test). When assessing regional and gender-related CBP consumption patterns, significantly higher rice consumption was found among CD women from Northern Italy compared to CD women from Central and Southern Italy (p = 0.006 and p = 0.002 respectively, Fisher’s exact test). No other significant differences were observed. Conclusions: Our results provide a snapshot of the overall consumption of CBP among Italian subjects with CD. Altogether, these data show that, despite minor differences, dietary consumption of CBP among CD patients is similar to the general population.

Mo1175 How Valuable Is “10-Time ULN Threshold” for Identifying Villous Atrophy in Screening-Detected Patients?

C.M. Trovato1,∗, M. Montuori1, F. Valitutti 1, P. De Luca1, L. Pezza1, C. Tiberti 3, D. Iorfida1, F. Lucantoni3, R. Nenna2, M. Mennini1, C. Anania1, M. Bonamico2, S. Cucchiara1 1 U.O.C. di Gastroenterologia ed Epatologia Pediatrica, Dip. di Pediatria e Neuropsichiatria Infantile, Sapienza Universita di Roma, Italy 2 Dip. di Pediatria e Neuropsichiatria Infantile, Sapienza Universita di Roma, Italy 3 Dip. di Medicina Sperimentale, Sapienza Universita di Roma, Italy

How valuable is “10-time ULN threshold” for identifying villous atrophy in screening detected patients?

C.M. Trovato1,∗, M. Montuori1, F. Valitutti 1, P. De Luca1, L. Pezza1, C. Tiberti 3, D. Iorfida1, F. Lucantoni3, R. Nenna2, M. Mennini1, C. Anania1, M. Bonamico2, S. Cucchiara1 1 U.O.C. di Gastroenterologia ed Epatologia Pediatrica, Dip. di Pediatria e Neuropsichiatria Infantile, Sapienza Universita di Roma, Italy 2 Dip. di Pediatria e Neuropsichiatria Infantile, Sapienza Universita di Roma, Italy 3 Dip. di Medicina Sperimentale, Sapienza Universita di Roma, Italy

Tu1134 Are ESPGHAN 2011 Guidelines for Celiac Disease Also Suitable for Asymptomatic Patients

positive scores on ASD screening questionnaires. Although only a small number meet criteria for a classic ASD, the majority meets criteria for other DSM-IV diagnoses. Further studies are needed to determine whether particular autistic-like behaviors, such as disruptive behaviors, are associated with particular phenotypes of FDDs or different outcomes. Physicians dealing with children with FDD need to be vigilant to uncover possible associated behavioral disturbances.