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Factors Affecting Prognosis in the Course of Pediatric Celiac Disease
Didem Taşkın1, Alihan Sursal2, Ali E Doğan3
1Pediatric Gastroenterology, Adana City Research and Training Hospital, Adana, TUR.
Insights
Treatment adherence is key for improving growth in children with celiac disease (CD). Early diagnosis and socioeconomic status also significantly impact recovery and anthropometric measurements in pediatric CD patients.
Area of Science:
- Pediatric gastroenterology
- Autoimmune disorders
- Chronic disease management
Background:
- Celiac disease (CD) is a common autoimmune disorder affecting children, often leading to impaired growth.
- Evaluating patient outcomes post-diagnosis is crucial for understanding prognosis in pediatric CD.
- This study focuses on factors influencing the recovery of growth parameters in children with CD.
Purpose of the Study:
- To assess the cross-sectional condition of pediatric celiac disease patients after diagnosis.
- To identify factors impacting the prognosis and recovery of growth parameters.
- To highlight the importance of early diagnosis and treatment adherence.
Main Methods:
- A single-center retrospective study of 211 pediatric patients (1-18 years) diagnosed with CD.
- Analysis of anthropometric data (BMI, weight, height z-scores) at admission and follow-up.
- Statistical evaluation of factors including treatment adherence, Helicobacter positivity, Marsh classification, socioeconomic status, and duration of symptoms.
Main Results:
- Treatment adherence significantly influences the improvement of developmental parameters (p<0.033).
- Longer duration of symptoms correlated with poorer weight z-scores at follow-up (p=0.033).
- Early diagnosis in asymptomatic cases showed better BMI z-score improvement (p=0.036), and patients without growth retardation improved faster (p<0.001).
- Higher socioeconomic status was linked to better anthropometric measurements at follow-up (p<0.002) due to easier dietary adaptation.
Conclusions:
- Treatment adherence is the most critical factor for improving outcomes in pediatric celiac disease.
- Investigating additional symptoms during follow-up is vital for early diagnosis of comorbidities.
- Early diagnosis and socioeconomic support are essential for optimal anthropometric recovery in children with CD.
Abstract:
Introduction Celiac disease (CD) is a rather frequent chronic autoimmune disease that causes impaired growth in children. The present study aims to evaluate patients' condition after diagnosis cross-sectionally and determine the factors affecting prognosis. Methods Control visits were performed at the end of the 13-month intervention period. The study was designed as a single-center retrospective study and included patients diagnosed with CD. The study cohort consisted of 211 patients aged 1 to 18 years. Statistical parameters include Helicobacter positivity, Marsh classification; economic status; and body mass index (BMI) z-score, weight z-score, and height z-score to observe the difference between admission and follow-up. Results Treatment adherence is one of the most critical factors influencing improvement in developmental parameters during control visits (p<0.033). It was observed that the weight z-scores at the control visit deteriorated significantly with a longer duration of complaints (p=0.033). Better improvement of control visit BMI z-scores among patients with complaints compared to asymptomatic patients (p=0.036) indicate the importance of early diagnosis in asymptomatic cases. Developmental parameters of patients with CD without growth retardation (GR) show faster improvement compared to patients with GR (p<0.001). Families with good socioeconomic status can easily adapt to the diet by reaching a greater variety of gluten-free products, so anthropometric measurements are observed to be significantly higher at the control visit (p<0.002). Conclusions Treatment adherence is the most critical factor for improvement in CD treatment, as in all treatments. In addition, the investigation of suspected, additional disease symptoms during the follow-up of a CD patient is also of great importance for early diagnosis. The importance of early diagnosis has been emphasized in terms of anthropometric improvement in asymptomatic CD cases.
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