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Clinical manifestations of celiac disease
Insights
Celiac disease (CD) presentation is evolving, with fewer classical diarrheal cases. Increased medical awareness is crucial for diagnosing this multisystem immune disorder.
Area of Science:
- Immunology
- Gastroenterology
- Internal Medicine
Background:
- Celiac disease (CD) is a multisystem immune disorder with diverse clinical presentations.
- Recent decades show a shift away from the classical diarrheal form, especially in children.
- Many individuals with CD remain undiagnosed due to common, non-specific symptoms.
Purpose of the Study:
- To describe the changing clinical manifestations of celiac disease.
- To highlight common presentations in children and adults.
- To emphasize the need for increased diagnostic awareness.
Main Methods:
- Review of clinical presentations of celiac disease.
- Analysis of trends in patient symptoms over recent decades.
- Identification of common diagnostic routes in pediatric and adult populations.
Main Results:
- Classical diarrheal presentation is less common, particularly in older children.
- In children, growth issues, screening of at-risk groups, and abdominal pain are frequent.
- In adults, diarrhea and anemia are most common, followed by bone disease and incidental findings.
Conclusions:
- Celiac disease manifestations have evolved, requiring broader diagnostic consideration.
- Increased medical education and awareness are essential to improve celiac disease diagnosis rates.
- Screening at-risk groups and recognizing subtle symptoms are key to identifying undiagnosed cases.
Abstract:
Celiac disease (CD) is an immune-based condition affecting multiple organ systems. Clinical manifestations are manifold in form and number due to the multisystem nature of CD. There has been a progressive change in the clinical manifestations over the recent decades with fewer patients, both adults and children, presenting with a diarrheal, classical form. This, in children, is seen in only the youngest, while growth issues, screening at-risk groups and recurrent abdominal pain are the most common modes of presentation among children. Among adults, diarrhea is the most common presentation followed by anemia. Screening at-risk groups, metabolic bone disease and incidental recognition at endoscopy performed for reflux are the other main modes of presentation. The bulk of those with CD remain undiagnosed. The symptoms are often common, and increased medical education should lead to greater awareness in the medical community and an increased rate of diagnosis.
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