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Coeliac disease in children of West Indian origin

J C Hung1, A D Phillips, J A Walker-Smith

  • 1Academic Department of Paediatric Gastroenterology, Queen Elizabeth Hospital for Children, London.

Insights

Coeliac disease is rare in non-European populations. However, this study highlights two cases in English-born West Indian children, suggesting it should be considered in this demographic presenting with chronic diarrhea.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Medicine
  • Genetics

Background:

  • Coeliac disease (CD) is an immune-mediated enteropathy typically associated with HLA-DQ2/DQ8 genotypes.
  • While historically considered uncommon in non-European populations, evolving diagnostic criteria and increased awareness are revealing its presence in diverse ethnic groups.
  • Genetic predisposition and environmental triggers, such as gluten exposure, are key factors in CD pathogenesis.

Observation:

  • Two cases of coeliac disease are presented in English-born children of West Indian origin.
  • Both children presented with chronic diarrhea, a common but non-specific symptom of coeliac disease.
  • These cases challenge the traditional understanding of coeliac disease epidemiology.

Findings:

  • The diagnosis of coeliac disease should be actively considered in pediatric patients of West Indian ancestry presenting with persistent diarrhea.
  • This observation suggests that coeliac disease may be underdiagnosed in this specific ethnic group.
  • Further research is warranted to understand the prevalence and potential unique clinical presentations of coeliac disease in West Indian populations.

Implications:

  • Clinicians should broaden their differential diagnosis for chronic diarrhea in children of West Indian origin to include coeliac disease.
  • Increased awareness and targeted screening may improve early diagnosis and management of coeliac disease in underrepresented populations.
  • Understanding the genetic and environmental factors contributing to coeliac disease in diverse ethnicities is crucial for global public health initiatives.

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