Article Text

CHANGING PATTERN OF PRESENTATION OF CELIAC DISEASE
  1. G Lesanu1,
  2. V Hurduc2,
  3. C Becheanu1,
  4. D Pacurar1,
  5. R Catu1,
  6. D Oraseanu1
  1. 1Grigore Alexandrescu Emergency Children Hospital, Bucharest, Romania
  2. 2Victor Gomoiu Emergency Children Hospital, Bucharest, Romania

Abstract

Objective The study investigates trends in clinical presentation of children diagnosed with celiac disease (CD).

Methods We performed a retrospective study on cases diagnosed with CD at Emergency Children Hospital in a period of 22 years. We compared two groups of patients: Group 1- children diagnosed from 1985 to 1995 and Group 2-children diagnosed from 1996 to 2006. Symptoms at presentation were classified as: typical gastrointestinal symptoms, atypical or milder gastrointestinal symptoms and extraintestinal symptoms.

Results Group 1 consisted of 20 children (mean age 5.9±4.7 years). Group 2 had 152 children (mean age 4.4±3.6 years). Typical gastrointestinal symptoms were encountered in 18 (90%) patients belonging to Group 1 and in 79 (51.9%) patients coming from Group 2 (p<0.002). Atypical or milder gastrointestinal symptoms in Group 1 and Group 2 were reported in 2 (10 %) vs. 49 (32.2%) patients (p<0.05). Extraintestinal symptoms were not reported in Group 1 and were noticed in 20 (13.2%) children in Group 2. Four (2.6%) patients in Group 2 were asymptomatic. Total villous atrophy was found in 15% patients in group 1 vs. 9.9% in group 2, subtotal villous atrophy in 60% vs. 23% and partial villous atrophy in 25% vs. 67.1% patients (p<0,002).

Conclusion There was a significant increase in the number of CD patients diagnosed during the last years. The clinical presentation has changed: prevalence of classic form decreased and we encountered more celiac children with extraintestinal symptoms or less suggestive gastrointestinal symptoms. Prevalence of mild enteropathy with partial villous atrophy increased.

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