Unrecognized Celiac Disease in Children Presenting for Rheumatology Evaluation

Area of Science:

• Pediatric Rheumatology
• Gastroenterology
• Autoimmune Diseases

Background:

• Clinical guidelines often overlook the connection between rheumatic conditions and celiac disease (CD).
• Previous studies indicate associations between rheumatic diseases and CD in both pediatric and adult populations.
• There is a need to investigate CD prevalence in children undergoing rheumatologic assessment.

Purpose of the Study:

• To determine the prevalence of celiac disease (CD) in children evaluated by pediatric rheumatology.
• To assess the clinical presentation of pediatric patients with CD in a rheumatology setting.

Main Methods:

• Retrospective chart review of 2125 patients evaluated by Pediatric Rheumatology from June 2006 to December 2013.
• Screening for CD was part of the standard initial serologic evaluation for all patients.
• Diagnosis of CD was confirmed by pediatric gastroenterology following serologic testing.

Main Results:

• 36 new cases of celiac disease (CD) were diagnosed, representing a 2.0% prevalence.
• The majority of CD patients presented with extraintestinal manifestations like myalgias, arthralgias, and rash.
• Musculoskeletal symptoms improved or resolved after initiating a gluten-free diet in diagnosed patients.

Conclusions:

• A 2.0% prevalence of celiac disease (CD) was found in children presenting for pediatric rheumatology evaluation.
• Extraintestinal symptoms are common in children with CD, underscoring the need for screening.
• Screening for CD is crucial for children undergoing rheumatologic evaluation to ensure timely diagnosis and management.