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[Celiac disease. Is its clinical pattern changing?]
J C Vitoria Cormenzana1, A Sojo Aguirre, M Corera Sánchez
1Departamento de Pediatría, Hospital de Cruces, Baracaldo, Vizcaya.
Insights
Celiac disease (CD) diagnosis in children often relies on intestinal biopsy. Modern diagnosis benefits from immunologic markers due to evolving, atypical symptoms in pediatric celiac disease.
Area of Science:
- Pediatric Gastroenterology
- Malabsorption Syndromes
- Immunology
Context:
- Celiac disease (CD) is a significant malabsorption syndrome in pediatrics.
- Diagnosis traditionally relies on peroral intestinal biopsy.
- Studied 178 patients with suspected CD between 1974-1988.
Purpose:
- To analyze the diagnostic trends and clinical presentations of pediatric celiac disease.
- To highlight the challenges in diagnosing CD with evolving symptomatology.
- To underscore the potential utility of immunologic markers.
Summary:
- 117 out of 178 suspected pediatric celiac disease cases were confirmed.
- Diagnosis occurred in the first year of life for 32.6% of patients.
- Observed a shift towards less apparent or atypical symptoms over time, alongside associated diseases.
Impact:
- Celiac disease presentation is changing, often with subtle or atypical symptoms.
- Diagnostic challenges necessitate exploring advanced diagnostic tools.
- Immunologic markers show promise in aiding the diagnosis of pediatric celiac disease.
Abstract:
Celiac disease (CD) is one of the most malabsorption syndromes in Pediatrics, its diagnosis being based on peroral intestinal biopsy. During the period 1974-1988 we have studied 178 patients with the suspected diagnosis of CD: diagnosis was confirmed in 117 whereas 22 are still under study. Mean age of the patients was 22.5 +/- 22.7 months, diagnosis being made during the first year of life in 32.6% of cases. Most cases had a classic clinical onset, although over the last year symptoms seen to be less apparent. Several patients presented with atypical forms. Also, associated diseases are observed in several cases. CD is often presented nowadays with few or atypical symptoms of difficult diagnosis and in this context the use of immunologic markers may be specially helpful.