Presenting symptoms of Celiac disease among children visiting the pediatric gastrointestinal clinic at king Hussein Medical Center

ABSTRACT

To determine the most common presenting symptoms of Celiac disease among children followed up at the Pediatric Gastrointestinal Clinic at King Hussein Medical Center. A retrospective review of 108 medical records of celiac disease patients followed up at the Pediatric Gastrointestinal Clinic at King Hussein Medical Center was conducted during a period of 10 years between 1996 to 2006. All patients' growth charts were reviewed at the time of presentation. All patients included in the study underwent an upper gastrointestinal endoscopy with duodenal biopsies and their histopathologic findings were consistent with the diagnosis of Celiac disease. Simple descriptive statistics [mean, frequency and percentage] were used to describe the study variables. Seventy-eight patients [72%] were females and 30[28%] were males. The youngest age at the time of presentation was 10 and 1/2 months and the eldest was 15 years with a mean age of 4yrs at the time of presentation. Twelve [11%] patients were found to have positive family history of Celiac disease. The growth charts of the patients showed body weight to be at or below the 5[th] centile except for 2, one was on the 25[th] centile and the other on the 50[th], and both of them presented with diarrhea and abdominal distention. Patients under 5 years of age were noticed to present mainly with gastrointestinal manifestations such as diarrhea and abdominal distension with failure to gain weight appropriately. Patients between 5 years to 12 years of age mostly presented with extraintestinal manifestations such as short stature and anemia, mostly iron deficiency anemia. Patients above 12 years of age mostly presented with short stature and some of them with pubertal delay. Early recognition of presenting symptoms of Celiac disease such as chronic diarrhea, failure to gain weight, anemia and short stature should prompt a thorough investigation for Celiac disease including serologic studies as well as upper gastrointestinal endoscopy with duodenal biopsy. Histology can provide the precise diagnosis after which glutean free diet should be started to improve the symptoms and avoid the complications