ABSTRACT
Celiac disease is a gluten dependent immune mediated enteropathy. Several gastrointestinal and immune disorders have been found in patients with Down syndrome. The association between Down syndrome and celiac disease has been reported to be between 4-17%. We aimed to look for the Prevalence and clinical manifestation of celiac disease in down syndrome patients in Kuwait. 126 down syndrome patients who where referred to our gastroenterology unit for celiac disease screening from the period 2006 till 2008 were reviewed. Patients charts were reviewed looking for those who have positive antiendomysial antibody and required upper endoscopy to confirm the diagnosis and identifying the number of patients who were proven to have celiac disease by histopathology. Gastrointestinal signs, symptoms and the presence of autoimmune diseases in patients with down syndrome were also reviewed. Out of the 126 down syndrome patients who were screened for celiac disease three patients2.4% were found to have celiac disease. The more frequent symptoms were vague abdominal pain 29 [22.7%], followed by constipation 25 [19.5%], skin rash 10 [7.9%], abdominal distention 10[7.8%], and irritability 7 [5.6%]. Regarding autoimmune diseases hypothyroidism was the most frequent 43 [33.9%], followed by Alopecia 7[5.5%], vitiligo 3 [2.4%], diabetes type 1 2 [1.6%], hepatitis 0 [0%], and pernicious anemia 1 [0.8%].One patient had coexistence of more than one autoimmune disorder hypothyroidism, celiac disease, and juvenile rheumatoid arthritis. screening of celiac disease in Down syndrome patients will help to avoid the harmful consequences of undiagnosed celiac disease, the time interval needs to be determined so, careful evaluation and long term follow up for children with Down syndrome is to be considered in view of the possibility of coexistence of more than one autoimmune disease