Aim To determine the changes in clinical presentation of Coeliac Disease in children aged less than 16 years over a period of 20 years (January 1996 to December 2015) at a DGH in England
Methods A retrospective case study of the clinical presentation of biopsy-proven Coeliac disease in children, at a DGH over a period of 20 years divided into four equal periods (1996–2000, 2001–2005, 2006–2010 and 2011–2015). Relevant information was extracted and input into an Excel database by a single researcher for further analysis.
Results Coeliac Disease was diagnosed in 114 children over the study period. Twelve children were excluded from final analysis. These comprised of 05 children with insufficient information and 07 children with Insulin-Dependent Diabetes Mellitus( IDDM) diagnosed with Coeliac Disease as a result of their annual screening investigations. Twenty (20) new cases of Coeliac disease were identified during each of the study periods 1996– 2000 and 2001–2005. This increased to 31 cases during the study periods of 2006–2010 and 2011– 2015. Although 85% of cases were diagnosed under the age of 12 years, there was a trend towards diagnosis at an older age and increasing female representation. Anaemia (53%) and diarrhoea (49%) were the commonest and most consistent symptoms. Constipation (10%) occurred in a significant minority. However, recurrent abdominal pain (46%) was not only a major symptom after the age of 3 years but increasingly likely from 2006 onwards with 71% affected in 2011– 2015. Abdominal distension (24%) remained relatively unchanged while faltering growth (27%) and small stature (8%) showed a decreasing trend. Vomiting (17%) was more likely in children under the age of 4 years.
Conclusion Although Coeliac Disease is being diagnosed more frequently, there is a trend towards diagnosis at an older age with increasing female representation. Iron deficiency anaemia and diarrhoea have remained unchanged as the commonest symptoms but recurrent abdominal pain is a significant symptom, especially in the older child. Constipation is found in a significant minority but both faltering growth and small stature show a decreasing trend.
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