Clinical biochemical and serological profile in Children with Celiac disease

Abstract

Background: Celiac disease (CD) is a chronic, immunologically determined form of enteropathyaffecting the small intestine, precipitated by the ingestion of gluten-containing foods such as wheatrye, barley etc. This study was taken up to analyze clinical manifestations and biochemical profile ofchildren with celiac disease presenting at KEM Hospital Pune. Methods: All children diagnosed as CDin last 5 years and newly diagnosed patients of celiac satisfying inclusion criteria for next 1 year.This is an observational descriptive prospective and retrospective study. CD was diagnosed based onpositive tTGA & duodenal biopsy in children with chronic diarrhea & other suggestive features.Hospital records were reviewed for complete follow up data. Results: In a study period of 12months we diagnosed 19 children with Celiac Disease, who were studied prospectively, whereas 31patients who were diagnosed within the last 6 years & were on regular follow up in OPD werestudied retrospectively. In the total group of 50 patients in the age range of 1year to 15 years. Thepresenting clinical features of our group of patients were: chronic diarrhea (92 %), failure to thrive(86%), abdominal pain (34%), abdominal distention (26%), anorexia/vomiting (8%/ 20%), &weight loss (8%). Rare features were fever, fatigue, blood in stools & constipation. In our studyanemia was seen in 76% of patients, 58% of prospective patients had low ferritin levels.Conclusions: In a study period of 12 months we diagnosed 19 children with Celiac disease whichgoes to go prove that Celiac Disease, is not rare in western Maharashtra. Most patients belonged tothe age group 1-5 years (50%) and the majority of patients were females (56%). Chronic diarrheawas the most common presenting complaint in all age groups ( 92%) followed by failure to thrive,not gaining weight and abdominal pain. Constipation was least common. Anemia was the mostcommon laboratory-confirmed finding and the most common type of anemia was iron deficiencyanemia. Prevalence Anemia was most common in below 5 yrs.