Celiac Disease in Childhood: Evaluation of 140 Patients

Objective: Celiac disease (CD) is a lifelong gluten-sensitive intestinal enteropathy that is multifactorial in its etiology. In the present study, we evaluated basic anthropometric, clinical, laboratory, and histological features of 140 Turkish children with CD. We particularly underscored the association of CD with other autoimmune diseases.

Materials and Methods: During the period from 1999 to 2005, CD was diagnosed in 140 children according to ESPGAN criteria. The age, gender, clinical findings, hematological, and biochemical parameters at diagnosis were noted. Symptoms and signs were recorded. Endoscopic intestinal biopsies were taken from all children.

Results: Of the 140 children with CD, 75 (53.6%) were female, and 65 (46.4%) were male. Mean age was 8.56 ± 4.43 years (range 13 months to 18 years). The most frequent symptom was failure to thrive (81.4%), followed by chronic diarrhea (60%). Of the children with CD, nine (6.4%) had type 1 diabetes mellitus (DM), six (4.3%) had familial Mediterranean fever, three (2.1%) had alopecia areata, three (2.1%) had vitiligo, three (2.1%) had Down syndrome, two (1.4%) had lung tuberculosis, two (1.4 %) had autoimmune hepatitis, two (1.4%) had growth hormone deficiency, one (0.7%) had osteogenesis imperfecta, and one (0.7%) had Floating Harbor Syndrome. Elevated serum levels of ALT, CK and AST were detected in 48(34.8%), 50 (38.2%) and 67 (48.6%) children, respectively.

Conclusion: The spectrum of clinical findings is very wide. In order to avoid overlooking CD in patients with extra intestinal symptoms and signs, physicians, especially pediatricians, should be informed about new atypical manifestations of CD.