Celiac disease in childhood: evaluation of 140 patients
Vildan Ertekin1, M Ayse Selimoglu2, Sevin Altinkaynak3
1Ataturk University, Faculty of Medicine, Department of Pediatric Gastroenterology Hepatology and Nutrition, Erzurum, Turkey.
Insights
Celiac disease (CD) in children presents with diverse symptoms, often including failure to thrive and chronic diarrhea. This study highlights the frequent co-occurrence of CD with other autoimmune conditions, emphasizing the need for broader clinical awareness.
Area of Science:
- Pediatric Gastroenterology
- Autoimmune Diseases
- Clinical Research
Background:
- Celiac disease (CD) is a complex autoimmune disorder triggered by gluten ingestion.
- Understanding the diverse clinical presentations and comorbidities of CD in children is crucial for timely diagnosis and management.
Purpose of the Study:
- To evaluate the anthropometric, clinical, laboratory, and histological features of 140 Turkish children diagnosed with celiac disease.
- To specifically investigate the association between celiac disease and other autoimmune diseases in this pediatric cohort.
Main Methods:
- A retrospective analysis of 140 children diagnosed with CD between 1999 and 2005 using ESPGAN criteria.
- Data collected included age, gender, clinical symptoms, hematological and biochemical parameters, and intestinal biopsy results.
Main Results:
- The study included 140 children (53.6% female), with a mean age of 8.56 years. Failure to thrive (81.4%) and chronic diarrhea (60%) were the most common symptoms.
- Significant comorbidities were observed, including type 1 diabetes mellitus (6.4%), familial Mediterranean fever (4.3%), alopecia areata (2.1%), vitiligo (2.1%), and Down syndrome (2.1%).
- Elevated liver enzymes (ALT, AST) and creatine kinase (CK) were noted in a substantial proportion of patients.
Conclusions:
- Celiac disease in children exhibits a wide spectrum of clinical manifestations, extending beyond typical gastrointestinal symptoms.
- Pediatricians and other healthcare providers must be aware of atypical presentations and potential co-existing autoimmune conditions to avoid diagnostic delays.
Objective:
Celiac disease (CD) is a lifelong gluten-sensitive intestinal enteropathy that is multifactorial in its etiology. In the present study, we evaluated basic anthropometric, clinical, laboratory, and histological features of 140 Turkish children with CD. We particularly underscored the association of CD with other autoimmune diseases.
Materials And Methods:
During the period from 1999 to 2005, CD was diagnosed in 140 children according to ESPGAN criteria. The age, gender, clinical findings, hematological, and biochemical parameters at diagnosis were noted. Symptoms and signs were recorded. Endoscopic intestinal biopsies were taken from all children.
Results:
Of the 140 children with CD, 75 (53.6%) were female, and 65 (46.4%) were male. Mean age was 8.56 ± 4.43 years (range 13 months to 18 years). The most frequent symptom was failure to thrive (81.4%), followed by chronic diarrhea (60%). Of the children with CD, nine (6.4%) had type 1 diabetes mellitus (DM), six (4.3%) had familial Mediterranean fever, three (2.1%) had alopecia areata, three (2.1%) had vitiligo, three (2.1%) had Down syndrome, two (1.4%) had lung tuberculosis, two (1.4 %) had autoimmune hepatitis, two (1.4%) had growth hormone deficiency, one (0.7%) had osteogenesis imperfecta, and one (0.7%) had Floating Harbor Syndrome. Elevated serum levels of ALT, CK and AST were detected in 48(34.8%), 50 (38.2%) and 67 (48.6%) children, respectively.
Conclusion:
The spectrum of clinical findings is very wide. In order to avoid overlooking CD in patients with extra intestinal symptoms and signs, physicians, especially pediatricians, should be informed about new atypical manifestations of CD.
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