|
Author Affiliations: Unit of Pediatric Gastroenterology Hepatology and Nutrition (Dinler G, Kalaycı AG) and Department of Pediatrics (Atalay E), Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
Corresponding Author: Gön¨¹l Dinler, Pediatric Gastroenterology Hepatology and Nutrition Department, Ondokuz Mayıs University Faculty of Medicine, Samsun 55139, Turkey (Tel: +90 3623121919-3734; Fax: +90 3624576041; Email: gdinler@omu.edu.tr)
doi:10.1007/s12519-009-0053-y
Background: Celiac disease presents with a spectrum of clinical disorders. The variety of clinical presentations largely depends on age and extraintestinal findings. This study aimed to determine typical and atypical cases according to presenting symptoms and to evaluate their biochemical and pathological parameters.
Methods: Eighty-seven patients with celiac disease in our unit between 2000 and 2007 were reviewed. Their diagnosis was made by serological and histological examination. The patients were divided into two groups according to their typical or atypical symptoms.
Results: The mean age of the patients at diagnosis was 8.2 years (range, 1-18 years), but patients presenting with typical symptoms were younger than those presenting with atypical symptoms. The patients in the two groups did not differ significantly in sex, weight and height Z scores except age. Diarrhea (96.3%), abdominal distention (65.4%) and failure to thrive (60%) were the most common clinical presentations in the typical group, and short stature (62.5%) and anemia (31.2%) were the most common in the atypical group. Total/subtotal villous atrophy was significantly higher in the typical group than in the atypical group.
Conclusions: Many children with celiac disease show an atypical form. The understanding of presentations of celiac disease may prevent delayed diagnosis. Celiac disease should be specially investigated in patients with recurrent iron deficiency anemia, short stature and autoimmune disorders.
Key words: atypical presentation; celiac disease; child; iron deficiency anemia; short stature
World J Pediatr 2009;5(4):282-286
|
