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An 8 year old girl is referred to the paediatrician because of her stunted growth. Her height SDS is −2.3 (≈1st centile); her weight for height ratio is +0.9 SDS (≈80th centile). At the age of 3 years, her height SDS was +0.3 (≈60th centile). Her weight for height ratio had not changed considerably. At the age of 4–5 years, she had several episodes of constipation and anaemia. There were no other complaints. A diagnostic work-up was performed: IgA anti-endomysium (IgA EmA) antibodies were positive. A small intestinal biopsy (gold standard) showed total villous atrophy, consistent with coeliac disease. During follow up, she fulfilled the ESPGAN criteria for coeliac disease (finding of characteristic small bowel mucosa abnormalities in a small bowel biopsy, and clinical remission when placed …
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