Diarrheal Versus Non-diarrheal Presentations of Paediatric Celiac Disease
Muhammad Almas Hashmi1, Tanveer Hussain2, Najaf Masood3
1Department of Paediatrics Gastroenterology, The Children's Hospital and The Institute of Child Health, Lahore.
Insights
Children with celiac disease (CD) who do not present with diarrhea are diagnosed later and experience more severe malnutrition. Early identification of atypical CD symptoms is crucial for better outcomes.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Medicine
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- CD presentation varies, with diarrheal symptoms being common but atypical presentations also occurring.
Purpose of the Study:
- To compare the clinical features and diagnostic frequencies of celiac disease in children with diarrheal versus non-diarrheal presentations.
- To identify differences in age at diagnosis and nutritional status between these two groups.
Main Methods:
- A cross-sectional study was conducted on 54 newly diagnosed pediatric celiac disease patients.
- Patients were categorized into diarrheal and non-diarrheal groups based on the presence of chronic or recurrent diarrhea.
- Diagnosis was confirmed by tissue transglutaminase (TTG) antibodies and intestinal histopathology.
Main Results:
- Of 54 patients, 31 (57.4%) had diarrhea, while 23 (42.6%) did not.
- The non-diarrheal group was diagnosed at a significantly later age (p=0.038).
- Severe malnutrition was more frequent in the non-diarrheal group (p=0.02), while short stature, anemia, rickets, clubbing, and abdominal distension were equally prevalent.
Conclusions:
- Atypical (non-diarrheal) presentation of celiac disease in children is associated with a higher age at diagnosis.
- Children with non-diarrheal celiac disease exhibit more severe malnutrition compared to those with diarrheal presentation.
- These findings highlight the importance of considering celiac disease in children with varied symptoms beyond diarrhea.
Objective:
To compare the frequencies and clinical features of diarrheal versus non-diarrheal presentation of celiac disease (CD).
Study Design:
Cross-sectional study.
Place And Duration Of Study:
Paediatric Department, Benazir Bhutto Hospital, Rawalpindi, from January to December 2013.
Methodology:
Children with celiac disease, newly diagnosed on the basis of tissue transglutaminasel (TTG) and intestinal histopathology, were included in the study by consecutive non-probability sampling. Patients were divided into diarrheal and non-diarrheal groups on the basis of presence or absence of chronic or recurrent diarrhea. Comparison between two groups was done and a p-value < 0.05 was considered significant.
Results:
Total patients were 54 (26 males, 28 females) with mean age of 6.67 ±3.35 years. Chronic diarrhea was present in 31 (57.4%) and absent in 23 (42.6%). Patients in non-diarrheal group were diagnosed at a significantly later age (p=0.038) and had a greater frequency of severe malnutrition (p=0.02). Short stature, anemia, rickets, clubbing and abdominal distension were equally prevalent. There was no significant difference in TTG value and intestinal histopathology among two groups.
Conclusion:
Children with atypical presentation of CD had significant severe malnutrition and higher age at diagnosis than at diarrheal presentation.
More Related Videos
Related Concept Videos
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:24Chronic Kidney Disease II: Clinical Manifestations
01:27Glucose Transporters
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:30Other Disorders of Digestive System
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...