Profil epidemiologique et evolutif de la maladie coeliaque de l'enfant [. propos de 118 cas]

ABSTRACT

We report a retrospective study about 118 children suffering from coeliac disease hospitalized in the pediatric department of CHU Sfax in a period of 16 years [1977- 1992]. They are 70 girls and 48 boys. The initial diagnosis made on an average age of 71 months, is based on the clinical and biological symptoms and on the histological data too [total villositary atrophy = 74 cases, subtotal villositray atrophy = 44 cases]. The patients are categorized into three different groups. Group 1 composed of 75 patients who have undergone only one initial intestinal biopsy- Group 2 composed of 30 patients who have undergone two intestinal biopsies one of which is initial and the other under gluten free diet. Group 3 composed of 13 patients who have undergone three intestinal biopsies [one initial, one under gluten- free diet and one after reintooduction f ghiten].under the ghiten free diet, 94 patients are regulary examined while 24 others have disappeared. After four months of evolution, we notice the disappearance of diarrhea in 73 cases and abdominal inflation in 71 cases. A staturo- ponderal growth reappeared in 57 cases. Among the 43 patients who had a control biopsy, 28 had normal histological aspect. The provocation test is realized with 19 patients has shown a histological drop in 100% of the cases. We insist on the efficiency of an early diagnosis based on the immunological techniques in addition to the intestinal biopsy and a better information to the patients and their families so as to avoid complication and to allow a normal growth and puberty