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Changing face and clinical features of celiac disease in children
1Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bezmialem Vakif University, Istanbul, Turkey.
Insights
Pediatric celiac disease (CD) presentation is evolving, with later diagnoses and increased non-classical symptoms observed. Metabolic bone disease (MBD) is a common complication in children with CD, requiring regular assessment.
Area of Science:
- Pediatric Gastroenterology
- Clinical Epidemiology
- Pediatric Endocrinology
Background:
- Celiac disease (CD) diagnosis and presentation in children have been subject to evolving trends.
- Understanding these changes is crucial for timely diagnosis and management.
Purpose of the Study:
- To compare the epidemiological and presenting features of celiac disease in children across two distinct time periods.
- To analyze clinical patterns and associated complications in pediatric celiac disease.
Main Methods:
- Retrospective analysis of clinical charts of children diagnosed with celiac disease.
- Comparison of patient data from two time periods: January 2005-October 2008 (group 1) and November 2008-April 2012 (group 2).
Main Results:
- The mean age at diagnosis was significantly higher in the later period (group 2: 9.3 years vs. group 1: 6.9 years).
- Non-classical presentations and associated disorders, including type 1 diabetes mellitus and isolated short stature, were more frequent in group 2.
- Overweight/obesity was noted in 5.8% of patients, and metabolic bone disease (MBD) was prevalent in 80.4% of those assessed.
Conclusions:
- The clinical presentation and features of pediatric celiac disease are changing over time.
- A significant proportion of children with celiac disease are overweight at diagnosis.
- Metabolic bone disease (MBD) is a frequent complication requiring routine evaluation in children with celiac disease.
Background:
The aim of this study was to analyze and compare the epidemiological and presenting features, clinical patterns, and complications of celiac disease (CD) in children.
Methods:
The clinical charts of children with CD were retrospectively analyzed. Data for children who presented during the first time period (January 2005-October 2008; group 1) were compared to those of children who presented during the second time period (November 2008-April 2012; group 2).
Results:
Group 1 and 2 consisted of 96 and 95 children, respectively. There were no differences in gender distribution, weight, or height z-scores between the two groups. Mean age at the time of diagnosis in group 2 (9.3 ± 4.5 years) was significantly higher than in group 1 (6.9 ± 3.9 years; P < 0.001). Non-classical presentation was more frequent in group 2 (P = 0.01). Associated disorders were observed in 49 children (25.7%) overall. There were significantly more children with type 1 diabetes mellitus in group 2 (P = 0.030). In all, 11 patients (5.8%) were overweight (either obese or at risk of obesity) at presentation. Isolated short stature was the presenting feature in 15 children (7.9%) overall, but was more frequently observed in group 2 (P = 0.003). In total, 15 patients (7.9%) presented with refractory iron deficiency anemia; the frequency was similar in both groups. Dual-energy X-ray absorptiometry was performed in 102 patients, and 82 (80.4%) had metabolic bone disease (MBD).
Conclusion:
The mode of presentation and clinical features of CD in childhood continue to change. Of note, a substantial percentage of patients were overweight at presentation. MBD is a frequent complication, necessitating routine evaluation.
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