Correlation of clinical characteristics and small bowel histopathology in celiac disease.
BACKGROUND
Literature information regarding clinical and histological correlates in celiac disease is limited. The present study was designed to assess the value of various clinical parameters in predicting the severity of small bowel histopathology.


METHODS
Small bowel biopsy specimens of 59 children with established celiac disease (ESPGAN criteria) were evaluated blindly. Morphology was evaluated based on a common histopathology score. The following clinical variables were evaluated: age at diagnosis, duration of symptoms, severity score of clinical symptoms, severity score of physical signs, and growth parameters (height and weight Z scores). Multiple regression analysis was performed to evaluate the relative importance of each clinical parameter.


RESULTS
Only three clinical variables revealed a significant correlation with the histopathology score. The symptom severity score (t = 3.883, p = 0.0003) demonstrated a positive correlation. The two others, age at diagnosis (t = 3.076, p = 0.0032) and duration of symptoms (t = -2.987, p = 0.0041), revealed a negative correlation.


CONCLUSIONS
We conclude that more severe clinical symptoms of a shorter duration, presented at a younger age, are better predictors of a more severe form of small bowel histopathology in children with celiac disease.
Weizman
Z
Z
Department of Pediatric Gastroenterology and Nutrition, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ben-Zion
Y Z
YZ
Binsztok
M
M
Maor
E
E
Porath
A
A
D000293:Adolescent; D001706:Biopsy; D002446:Celiac Disease / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008499:Medical Records; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index