Epidemiology of Celiac Disease in The Children Presenting at The Tertiary Care Hospital of Pakistan

Abstract

Objective: To determine the epidemiology of coeliac disease in the children presenting at the tertiary care hospital.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Department of Paediatrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Apr 2015 to Jul 2016.
 Methodology: Ninety-five consecutive children presenting with the suspicion of celiac disease were included in this study after taking written informed consent. A pre-designed proforma was used to record the patient's demographic details and the presenting complaints, laboratory, endoscopic and histological findings.
 Results: The mean age of the patients was 6.48 ± 3.20 years and the majority 53 (55.8%) of the children, were aged between 5 to 10 years. Failure to thrive was the most frequent presenting complaint and was recorded in 53 (55.8%) children, followed by pallor (54.7%), chronic diarrhoea (34.7%), short stature (29.5%), pain abdomen (28.4%) and recurrent vomiting (6.3%). The patients' haemoglobin ranged from 5.3 g/dl to 12.8 g/dl with a mean of 8.81±1.24 g/dl. The serum Anti-tTG level ranged from 8.0 U/ml to 759.0 U/ml with a mean of 298.75 ± 225.51 U/ml. Upon endoscopy, atrophic mucosa was revealed in 60 (63.2%) children, while 24 (25.3%) children had normal mucosa. Partial villous atrophy was the most frequent histological diagnosis (37.9%). Normal duodenal mucosa was reported in 4 (4.2%) children, while 21 (22.1%) children had mild non-specific duodenitis. Frequency of pallor (p=0.025), anaemia (p=0.017) and complete villous atrophy on histology (p=0.004) were significantly higher in patients with higher anti-tTG levels.
 Conclusion: Celiac disease has a diverse presentation for age, gender and clinical and biochemical markers.