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Comparison of Endoscopic and Histological Findings between Typical and Atypical Celiac Disease in Children

Pooja Semwal1, Raj Kumar Gupta1, Rahul Sharma2

  • 1Department of Paediatric Medicine, Sawai Man Singh Medical College, Jaipur, India.

Pediatric Gastroenterology, Hepatology & Nutrition
|May 2, 2018
PubMed

Insights

Duodeno-endoscopic features like scalloping and mosaic patterns are key indicators for diagnosing celiac disease in children. Recognizing these endoscopic markers aids in the early detection of both typical and atypical celiac disease presentations.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Endoscopy
  • Celiac Disease Diagnosis

Background:

  • Celiac disease is a prevalent non-communicable condition with diverse clinical manifestations.
  • Accurate diagnosis in children relies on understanding varied presentations and endoscopic findings.

Purpose of the Study:

  • To identify duodeno-endoscopic features associated with celiac disease in children.
  • To compare endoscopic and histological findings between typical and atypical celiac disease cases.

Main Methods:

  • An observational study involving 101 pediatric patients (age 1-18 years) with serology-positive celiac disease.
  • Patients were categorized into typical and atypical groups based on symptoms.
  • Upper gastrointestinal endoscopy and duodenal biopsies were performed and analyzed statistically.

Main Results:

  • Atypical celiac disease presentations were more common in older children.
  • Endoscopic findings such as scalloping, mosaic pattern, and reduced/absent fold height were significantly more frequent in the typical celiac disease group.
  • Advanced Marsh stages in histology were also significantly higher in the typical group.

Conclusions:

  • Duodeno-endoscopic features including scalloping, mosaic pattern, reduced fold height, and nodularity are crucial endoscopic markers for diagnosing celiac disease in children.
  • Awareness of these endoscopic signs is vital for early diagnosis, especially in children with atypical presentations or those undergoing endoscopy for other indications.
  • Integrating endoscopic findings with histology improves diagnostic accuracy for pediatric celiac disease.
Abstract

Keywords:
Celiac diseaseChildEndoscopyHistology

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