The clinical characteristics of celiac disease in children at the time of detection

Abstract

Objective - The aim of this study is to analyse the clinical characteristics of celiac disease at the time of its detection in relation to the age of the patient.

Subjects and Methods - Through examining the medical documentation of patients with celiac disease from the Department of Paediatrics in Tuzla (January 1st 1995 to March 31st 2011), the clinical symptoms and signs of the disease were analysed. The diagnosis of celiac disease was established on the basis of the criteria prescribed by the European Society for Pediatric Gastroenterology Hepatology and Nutrition. The subjects were divided into three groups: ages 0-1.9; 2-10.9, and 11- 14.9 (younger, middle, older), and, depending on the particular type of celiac disease, into groups with typical or atypical forms of the disease. The results are presented in the form of absolute and relative numbers.

Results - Seventy-two subjects were examined. The typical form of the disease was found in 46 subjects (26 girls and 20 boys), while the atypical form was found in 26 subjects (21 girls and 5 boys). In subjects with the typical form of the disease the main symptoms and signs in all age groups included: frequent stools, loss of body mass (BM), loss of appetite and paleness of skin. BM lower than the 25th percentile in the older age group was found in three children, while a body mass index (BMI) below the 25th percentile was found in more than half of all the subjects. In subjects with the atypical form of celiac disease, paleness of skin was the most common clinical sign for all three groups. Loss of body mass was found in more than half the subjects in all three age groups. BMI below the 25th percentile in the younger group was found in six subjects, while in the older group there were only three. BMI below the 95th percentile was found in two children from the older group.

Conclusion - The most common signs of the disease among the children with the typical form of the disease included, regardless of age, the following: frequent stools, loss of BM, loss of appetite and paleness of skin. In the atypical form of the disease the most common sign of the disease in all three groups was paleness of skin, while a BMI higher than the 95th percentile was found in two children, which implies the necessity of considering celiac disease in cases where there are no clinical symptoms or signs of malabsorption.