Atypical celiac disease in riskgroup in children
Journal Title: Pediatria Współczesna. Gastroenterologia, Hepatologia i Żywienie Dziecka - Year 2006, Vol 8, Issue 2
Abstract
Introduction: During last 20 years clinical course of celiac disease changed mostly into atypical, often with clinical manifestation outside of the gastrointestinal tract. Objectives: The aim of the study was to evaluate the prevalence of atypical celiac disease in riskgroups of children. Materiał and methods: We studied 645 children aged 7 months-17.5 years with irritable bowel syndrome (IBS) (n=219), epilepsy (n=74), attention-deficit/hyperactMty disorder (ADHD) (n=93), autism (n=62), short stature and Iow weight (n=112) and the group with other symptoms (n=85) including anaemia, autoimmune hepatitis, idiopathic hypertransaminaesemia, cirrhosis and osteoporosis. In all patients im- munofluorescence anti-endomysium (EmA) and immunoenzymatic anti-transglutaminase (tTC) antibody tests were performed. In case of positive serological tests a smali bowel biopsy was taken for histological analyses according Marsh scale. Results: Positive screening tests were found in 11 children (the prevalence 1:58) having symptoms of IBS (n=4, 1:54), ADHD (n=3, 1:31), short stature and Iow weight (n=2, 1:56), anaemia (n=1), cirrhosis (n=1). Histological analysis showed signs of mucosa damaged in 8 out of 10 analyzed biopsies. Normal mucosa was found in 2 children with ADHD. Five children presented Marsh III lesions, one Marsh II and two Marsh I. Children with Marsh III were affected by IBS (n=3), cirhosis (n=1) and anaemia (n=1), with Marsh II by IBS (n=1), with Marsh I by ADHD and short stature and Iow weight. Conclusions: Duetothehigh prevalence of atypical celiac disease, screening test should be performed at least in riskgroups of children.
Authors and Affiliations
Barbara Burda-Muszyńska, Beata Oralewska, Bożena Cukrowska, Maria Zielińska-Michałkiewicz, Marzena Olszaniecka, Anna Stolarczyk, Jerzy Socha
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