[Cancer in children with celiac disease. Gluten-sensitive enteropathy in a boy operated for Wilms tumour].

In adults untreated coeliac disease (CD) is associated with a wide variety of malignant complications. The overall mortality in CD is approximately twice that of the general population. The excess deaths are due mainly to intestinal lymphoma. In Europe, only 26 cases of CD and cancer in children have been published. There is evidence that cancer and CD in children are underreported. We report a case of Wilms tumour in a child who developed CD. As a neonate the boy had been successfully operated for congenital mesoblastic nephroma. Gluten was introduced in his diet at age of 12 months. He developed vomiting, abdominal distention ad hypertransaminosaemia. Up to the age of 16 months he had lost 1500 g and coeliac crisis was diagnosed (IgAEMA titre 1:50 and in the duodenal biopsy specimen there was crypt hyperplastic total villous atrophy). Symptoms improved rapidly when gluten-free diet was initiated, and 4 years later, clinical and serological findings were normal. Wilms tumour accounts for 6% to 7% of all childhood malignancies. There are no reports in MEDLINE about coeliac disease in patients who have been operated for the tumour. This seemed intriguing because prevalence of gluten-sensitive enteropathy calculated for Europe varies between 1/100 and 1/300.