Abstract
BackgroundCeliac disease (CD) is an immune mediated inflammatory enteropathy, triggered by gluten exposure in HLA-DQ2 and/or –DQ8 genetics. The presentation of celiac disease in children is changing, with increase in non-classical symptoms. We aim to evaluate the clinical presentations of celiac disease amongst children, diagnosed with CD.MethodsIn this cross sectional study, we investigated the clinical features of 130 celiac patients at hospitals affiliated with Shiraz University of Medical Sciences. We used their hospital charts and conducted an interview with patients and their parents to find out demographic data, symptoms, laboratory, and histopathology findings for Marsh grading.ResultsCeliac disease was detected more amongst females (63.8%). We found that 5.4% of the patients had BMI more than 95th percentile. The most common GI symptoms were abdominal pain, flatulence and constipation. Also, the most common extra intestinal manifestation included bone pain, long term fatigue and anemia. Flatulence, chronic diarrhea, and paresthesia were observed more amongst male participants. The most common comorbidities were type 1 diabetes mellitus and hypothyroidism.ConclusionThe most common gastrointestinal symptoms amongst our patients were abdominal pain, flatulence and constipation. Furthermore, the most common extra intestinal manifestations included bone pain, long term fatigue and anemia. The most associated comorbidities with CD in our children were type 1 diabetes mellitus and hypothyroidism.
Highlights
Celiac disease (CD) is an immune mediated inflammatory enteropathy, triggered by gluten exposure in HLA-DQ2 and/or –DQ8 genetics
CD was diagnosed according to the American College of Gastroenterology (ACG) clinical guideline [9], and was confirmed by positive serological test e.g. anti-tissue transglutaminase (TTG) and by performing upper endoscopy and having positive pathological results
These patients were under treatment in pediatric gastroenterologists in celiac clinics affiliated with Shiraz University of Medical Sciences (SUMS)
Summary
Celiac disease (CD) is an immune mediated inflammatory enteropathy, triggered by gluten exposure in HLA-DQ2 and/or –DQ8 genetics. Most patients remain undiagnosed due to iceberg pattern of celiac clinical symptoms and its various clinical presentations [4]. This means that many patients have silent celiac disease [5]. Celiac disease is a relatively common cause of chronic diarrhea in Iran, a Middle Eastern country, and is diagnosed in 2–8% of patients with type diabetes in Iran, Israel and Saudi Arabia. Many of these countries have a per capita wheat consumption, ranking amongst the highest in the world [7]. This is difficult in the absence of any supply of gluten free diet in Middle Eastern countries
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