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        Oral iron therapy resistant anemia and elevated liver enzymes can
be the first manifestations of celiac disease. It is well known and we try
to teach this features of CD to the medical students and residents here at
the University of Maryland.
        An other post  concerning the diarrhea, negative serology testing
suggests that this child may have celiac disease. There are lot of causes
of diarrhea. Furthermore, after a diarrheal disease certain children have
a postenteritis syndrome with loose stools for occasionally several weeks.
This is generally a self-resolving condition. The disappearence of
diarrhea on a gluten-free diet can be a coincidence and would not confirm
celiac disease and does not justify a life-time gluten-free diet. If there
is any doubt regarding the serology test it is best to do an intestinal
biopsy now (and not on a gluten-free diet).
        This not a medical advice.

Karoly Horvath
Baltimore