Coeliac disease in Saudi-Arab children

ABSTRACT

The clinicopathological features of 19 children with coeliac disease seen at King Khalid University hospital, Riyadh, over a 5-year period are described. Their mean age at presentation, introduction to cereals and onset of symptoms were 4.5 years, 0.7 years and 2.0 years respectively. The main symptoms were diarrhoea in 1 7 patients [89%] and failure to thrive in 13 [68%]. The main physical signs at admission were abdominal distension in 16 patients [86%], wasting in 15 [78%], pallor in 12 [63%], oedema in 5 [27%], and short stature in one [5%]. The mean haemoglobin, serum folate level and 1 h blood D-xylose were 9.1 g/dl, 1.4 ng/ml and 0.9 mmol/l respectively. The initial Jejunal] biopsy showed subtotal villous atrophy in every patient. Repeat biopsy showed normal villi in 10 patients while on gluten-free diet and subtotal villous atrophy on gluten challenge in four patients. There was considerable delay in establishing the diagnosis. All improved on a gluten-free diet