Clinical Profile of Children with Celiac Disease in Gujarat.

ABSTRACT

Introduction: Celiac Disease (CD), an autoimmune enteropathy, triggered by the ingestion of gluten in genetically susceptible individuals, is one of the commonest causes of malabsorption in the west. It is now well documented from north India where wheat is the staple diet. We report here 22 children of CD from Gujarat to bring the awareness amongst the pediatricians for its early diagnosis. The clinical presentation, serological tests & duodenal biopsy confirms the diagnosis. The results of Gluten Free Diet (GFD) are quite gratifying. Methodology: Retrospective analysis of presentation of children diagnosed to have CD was done from maintained database of CD patients of last 5 years. Results: Twenty two children were diagnosed to have CD at our centre in last 5 years. The age of presentation was from 14 months to 11 years. Short stature, pallor & chronic diarrhoea were the commonest features. Distention of abdomen, anorexia, pain in abdomen & oedema were other manifestations. Vomiting, voracious appetite, irritability & dermatitis were also noted in some cases. Rickets, rectal prolapse & clubbing were less common findings. Serological tests, besides routine investigations & duodenal biopsy confirmed the diagnosis. Gluten Free Diet (GFD) showed impressive results in 3 to 6 months time. Conclusion: CD is well documented in north India, but it also exists in Gujarat. With clinical presentation of stunted growth, chronic diarrhoea & unexplainable anaemia, one should think of CD. Some other less common & atypical features should also be kept in mind. The results of serological tests for CD are fairly reliable. Still, it is mandatory to confirm the diagnosis by duodenal biopsy. The results of GFD are quite rewarding. To emphasize for compliance of GFD & to provide the list of GFD to the parent & regular follow up are essential components of management.