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Allan Gardyne wrote:

> I've received a long, fascinating letter from a man who says he
> has documented evidence that the gluten intolerance he suffered
> from as a child has gone into remission. Wouldn't it be nice...
>
> I've posted his letter on my web site at
> http://www.ozemail.com.au/~coeliac/celiac2.html

I've read the letter.  To summarize, the man was diagnosed at two years
of age in 1951 with celiac disease.  He suffered from ricketts that left
one leg shorter than the other and caused a club foot.  He stayed
gluten-free until age 16, when he decided he was in "remission".  In
1970 he had a biopsy done as part of a family study, and they found his
intestines to be completely healthy.  He remains feeling healthy to
this day.

There are two points to consider:

  1. How was the initial diagnosis done?  Did they do a biopsy in 1951,
     or was he diagnosed based on his symptoms and response to diet?  In
     other words, can we be sure he really is a celiac at all?

  2. The 1970 biopsy was done using the old "capsule" technique, in
     which you swallowed a capsule, waited for it to enter the small
     intestine, and then got a sample.  (As he says himself, "...kids,
     don't try this at home.")  Besides being uncomfortable, this method
     was far less reliable than current methods.  If the damage were
     "patchy", and the sample were taken from a healthy area, then the
     damage could go undiscovered.

When you get measles, your immune system develops an antibody
specifically for fighting measles off.  Then, for the rest of your life
your immune system has the ability to produce this antibody whenever
an attack of measles threatens, so that you never get sick with measles
again.

My understanding is that this same mechanism is at work in celiac
disease.  In a celiac, the immune system develops an antibody which
tries to "fight off" the toxic part of gluten as if it were also some
kind of germ.  As a consequence of this fight (which naturally occurs in
the small intestine), the villi get damaged.  So if a celiac regularly
eats gluten their immune system is constantly in "attack" mode,
producing more and more antibodies against the gluten and causing more
and more damage.

I don't think that celiac disease can go into remission.  Just as in the
case of measles, once your immune system develops an antibody to gluten
(actually, to portions of the gliadin component in gluten), it will
ALWAYS be able to produce it anytime it perceives a threat.  So once
celiac disease is triggered, the body will forever react to the gluten
by trying to fight it off with antigliadin antibodies.  At different
times in your life this may affect you in different ways, sometimes
severe, sometimes not; but there is still damage going on and all the
attendant risks that stem from it.

In this case, I would conclude either:  1) This man never was a celiac
and his initial diagnosis in 1950 was incorrect, or 2) The biopsy in
1970, done using older, less reliable techniques, failed to find damage
that was possibly patchy.  If "2)" is correct, then he is at risk for
downstream complications such as bone disease or lymphoma.  I hope for
his sake that he will have a biopsy and determine whether he falls under
"1)" or "2)"

In any case, I don't believe he is a celiac in remission, as I don't see
how such a remission would be possible.  (NOTE:  I am not a medical
professional; these are the thoughts of a celiac parent.)

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-- Jim Lyles ................... Home: [log in to unmask]
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