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Age-related clinical, serological, and histopathological features of celiac disease

Santiago Vivas1, Jose M Ruiz de Morales, Marisa Fernandez

  • 1Department of Gastroenterology, Instituto de Biomedicina, University of León, León, Spain.

The American Journal of Gastroenterology
|August 16, 2008
PubMed

Insights

Celiac disease presents differently in children and adults, with children showing more severe symptoms and faster diagnosis. Human antitissue transglutaminase IgA antibody levels correlate with disease severity and patient age.

Area of Science:

  • Gastroenterology
  • Pediatric Gastroenterology
  • Immunology

Background:

  • Celiac disease (CD) is a prevalent autoimmune disorder affecting both pediatric and adult populations.
  • Limited comparative data exist regarding age-specific differences in CD presentation and diagnosis.

Purpose of the Study:

  • To prospectively compare the clinical and histological features of celiac disease at diagnosis in children versus adults.
  • To investigate age-related variations in celiac disease presentation and diagnostic markers.

Main Methods:

  • Prospective enrollment of 66 children and 54 adults diagnosed with celiac disease between 2000-2006.
  • Clinical symptoms categorized as typical (malabsorption, diarrhea, failure to thrive) or oligosymptomatic.
  • Histological findings classified as mild (Marsh I-IIIA) or severe (Marsh IIIB-IIIC); human antitissue transglutaminase IgA antibodies (TTGA) measured.

Main Results:

  • A higher female-to-male ratio was observed in adults (5.7:1) compared to children (1.6:1).
  • Typical symptoms were more frequent in children (62.5%) than adults (31%).
  • Diagnosis time was significantly shorter in children (7.6 months) versus adults (90 months).
  • Children exhibited higher TTGA levels, marked villous atrophy (86% vs 52%), and inverse correlation of atrophy with age.
  • TTGA levels correlated positively with age and villous atrophy severity in children.

Conclusions:

  • Celiac disease exhibits distinct age-related clinical and histological manifestations at diagnosis, with children presenting more severe features.
  • Human antitissue transglutaminase IgA antibody levels are associated with disease severity and patient age, offering diagnostic insights.
Abstract

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