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Changing pattern in the clinical presentation of pediatric celiac disease: a 30-year study
Eleftheria Roma1, Joanna Panayiotou, Helen Karantana
1First Department of Pediatrics of Athens University, Aghia Sophia Children's Hospital, Athens, Greece. roma2el@otenet.gr
Insights
Pediatric celiac disease (CD) presentation is changing in Greece, with more diagnoses in older children and atypical symptoms. Increased serological screening detects silent cases, highlighting the need for broader diagnostic consideration.
Area of Science:
- Pediatrics
- Gastroenterology
- Epidemiology
Background:
- Celiac disease (CD) incidence has risen due to better recognition of atypical and silent forms.
- Serological screening aids in identifying previously undiagnosed cases of CD.
- Understanding temporal trends in pediatric CD presentation is crucial for public health.
Purpose of the Study:
- To analyze temporal trends in the clinical presentation of pediatric celiac disease in Greece.
- To investigate changes in diagnostic patterns and patient demographics over time.
- To identify shifts in symptomology and detection methods for pediatric CD.
Main Methods:
- Retrospective review of medical records for children diagnosed with CD between 1978 and 2007.
- Classification of cases by year of diagnosis to assess temporal changes.
- Analysis of demographic data, presenting symptoms, diagnostic delay, and associated conditions.
Main Results:
- A significant increase in pediatric CD incidence was observed in recent years.
- Trends indicated older age at diagnosis, longer diagnostic delays, and a decrease in classical gastrointestinal symptoms.
- CD diagnosis increasingly resulted from screening asymptomatic children with family or associated condition history.
Conclusions:
- The presentation of pediatric celiac disease in Greece is evolving.
- CD is now more frequently diagnosed in older children, often with atypical symptoms.
- Increased serological screening contributes to earlier detection, emphasizing consideration of CD in diverse clinical scenarios.
Background/Aims:
The incidence of celiac disease (CD) has increased in recent years due to the recognition of atypical forms and the identification of silent cases through serological screening. Our aim was to detect temporal trends in the presentation of pediatric CD in Greece.
Methods:
We reviewed the medical files of all children diagnosed with CD between 1978 and 2007 at a single academic pediatric center. Cases were classified according to the year of diagnosis. We examined demographic data, presenting symptoms, delay to diagnosis, and the prevalence of associated conditions.
Results:
During the study period, 284 new cases of CD were diagnosed. The incidence of CD was significantly increased in recent years (p < 0.05). We observed significant trends towards older age at diagnosis (p < 0.001), longer delay to diagnosis (p < 0.05) and decreased frequency of the classical and/or gastrointestinal predominant mode of presentation (p < 0.001). In recent years, diagnosis of CD was significantly more frequent due to testing of asymptomatic children with a positive family history for CD or personal history of associated conditions (p < 0.001).
Conclusion:
We report a changing pattern in the presentation of pediatric CD in Greece. CD is diagnosed more frequently in older children, oftentimes presents with atypical symptoms, and is increasingly detected through serological screening. CD should be considered in the presence of atypical presentations.
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