Coeliac disease: Evaluation of diagnosis in children and teenagers

Abstract

BackgroundCoeliac disease is no longer a rare disease, but has a rising prevalence, especially in children, with a shift from malabsorption syndrome to a more subtle presentation. Therefore, European guidelines regarding the diagnosis of coeliac disease were changed in 2012. If laboratory tests are positive, children can now be diagnosed without performing an endoscopy.The aim of this study was to characterize the Swiss patients, who have been diagnosed with coeliac disease. MethodsThis is a retrospective study of Swiss paediatric patients who have been diagnosed with coeliac disease according to European guidelines between 01/2011 and 11/2020. The data needed was extracted from medical records. ResultsA total of 369 children were included in the study. The main complain was abdominal pain (118; 32%), followed by failure to thrive/gain weight (92; 24.9%). 10% (37/367) of all patients had no symptoms at all. In 72.6% (268/369) of all patients, an endoscopy was performed due to lower antibodies. Mean values for ferritin, vitamins D and B12 as well as folic acid were within normal range. ConclusionIn our cohort of patients, females were clearly more often affected and also showed a small deviation in height and weight. Our finding of 10% of all patients having no symptoms at all is in line with other studies observing a decline in symptoms. A complicating factor for the clinician is the fact that overall no vitamin deficiencies were detected. As the incidence continues to rise but the clinical presentation of coeliac disease is changing from a malabsorption syndrome to a silent disease, further observational studies are needed to monitor this trend.