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Abstract
Aims Literature suggests a changing paediatric presentation of coeliac disease. To evaluate this in an Irish setting, we looked at our coeliac patient cohort who were linked with the dietetics service in our tertiary referral centre over a six year period.
Methods Data was obtained from 195 patients, identified through our prospective dietetics database. Patients either had elevated TtG or positive histology. Screening reasons included failure to thrive (n = 17), Low iron (n = 19). Gastrointestinal symptoms were highly reported with Vomiting (n = 31), abdominal pain (n = 135), constipation (n = 60), diarrhoea (n = 76).
Results Diagnostic bloods and biopsies in this group were as follows (see Table 1).
Diagnostic bloods and biopsies in this group were as follows:
Of note, the patients with a positive biopsy with TtG < 7 (n = 19) presented with gastrointestinal complaints: diarrhoea (n = 13), constipation (n = 10) abdominal pain (n = 14) and vomiting (n = 1) often a combination.
Anthropometry at diagnosis (n = 132,%) revealed BMI average of 17.85. Considering BMI variances this places our children within normal-higher ranges. BMI centiles were obtained in 123 (62%) findings are as follows (see Table 2):
Anthropometry at diagnosis
Based on this initial data we conducted a chart review on our biopsy positive patients over an 18 month period.
Anthropometry again showed healthy weights, with BMI calculated in 45% (n = 25), the average of which was 15.655. Weight centiles showed highest distribution in the 50–75th centile (n = 10) and 90–98th (n = 8).
Interestingly pre-diagnosis 32%of this group were documented to have Gastrointestinal symptoms. TTG was elevated in 90%, indicating high level of opportunistic screening.
Conclusions The majority of our patients demonstrated a normal-high BMI.
Only one patient had negative biopsies with tTg > 70. This patient would have been excluded from biopsy based on current NICE guidelines.