Letter: Cystic fibrosis and coeliac disease.

The coexistence of cystic fibrosis and coeliac disease has recently been reported, 
and it has been suggested that cystic fibrosis may predispose to 
the later development of coeliac disease. The diagnosis of coeliac disease 
is largely dependent upon the demonstration of histological changes in the 
small intestine, but jejunal biopsy may be distressing to a small 
child. It is suggested that food protein antibody studies may be 
of value in the investigation of children with cystic fibrosis in 
whom gluten sensitivity is suspected. In the following case the decision 
to perform a jejunal biopsy was made when these studies were 
positive. Food protein antibody to cereal antigens, wheat, oatmeal, and gluten, 
and to ruminant antigens, cow's milk, and calf serum were persistently 
detected in the patient's blood. Jejunal biopsy showed partial villous atrophy 
with shortening, broadening, and branching of the villi. There was a 
satisfactory clinical improvement after gluten restriction. 