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Abstract

Objective: To evaluate effectiveness of treating previously untreated patients withceliac disease with both a gluten free diet and bisphosphonate in order to significantly increasetheir BMD’s to a greater extent than a gluten free diet alone. Patients and methods: The studywas conducted in National Institute of Child Health (NICH) Karachi to evaluate the effectiveness oftreating previously untreated patients with celiac disease with a gluten free diet andbisphosphonate in terms of increase in bone mineral density in comparison to a gluten free dietalone over a period of three months (January 2013 – March 2013). The study includes 30 childrenpatients below fifteen years of age either sex. All study subjects were untreated celiac patientsdiagnosed by clinical presentation, small bowel histology and serologic testing. On day dexascan was done. Fifteen patients kept on Gluten Free Diet (GFD) and remaining 15 patients keptGFD plus tablet of bisphosphonate. After three months dexa scan was repeated. The patientswith other disease of bone or mineral metabolism, as well as subjects taking systemicglucocorticoids or high doses of thyroid hormones, were excluded. Results: A total of 30 patientswith celiac disease were included in this study. Out of 30 patients 18 (60%) were female and 12(40%) male (M: F = 1:1.5). Thirty patients were divided in two equal groups (15 patients in eachgroup). In group-I we gave gluten free diet and in group-II we gave gluten free diet and one tabletof bisphosphonate. Mean± SD of Bone Mineral Density (BMD) in group-I was 0.402± 0.081gm/cm2 (range=0.234 – 0.503 gm/cm2), and in group-II was 0.543± 0.098 gm/cm2 (range=0.402 – 0.743 gm/cm2), mean difference of bone mineral density was significant between twogroups (P-value=0.0002). Conclusions: At three months DEXA scan showed a significant rise inBMD in group-II as compared to group-I