title: Prevalence and clinical picture of celiac disease in italian down syndrome patients: a multicenter study.
abstract: BACKGROUND
  A multicenter research study of Down syndrome patients was carried out to estimate the prevalence of celiac disease in patients with Down syndrome and to show clinical characteristics and laboratory data of Down syndrome patients.
  
  
  METHODS
  The authors studied 1,202 Down syndrome patients. Fifty-five celiac disease patients (group 1) were compared with 55 immunoglobulin A antigliadin-positive antiendomysium antibodies-negative patients (group 2) and with 57 immunoglobulin A antigliadin-negative antiendomysium antibodies-negative patients (group 3).
  
  
  RESULTS
  Celiac disease was diagnosed in 55 of 1,202 Down syndrome patients (4.6%). In group 1, weight and height percentiles were shifted to the left, whereas these parameters were normally distributed in groups 2 and 3. In celiac patients, diarrhea, vomiting, failure to thrive, anorexia, constipation, and abdominal distension were higher than in the other two groups. Low levels of hemoglobinemia, serum iron, and calcium were observed more frequently in group 1. The diagnosis of celiac disease was made after a mean period of 3.8 years from the initiation of symptoms. Sixty-nine percent of patients showed a classic presentation, 11% had atypical symptoms, and 20% had silent celiac disease. Autoimmune disorders were more frequent (30.9%) in group 1 than in the other two groups examined (15%; P < 0.05).
  
  
  CONCLUSIONS
  This study reconfirms a high prevalence of celiac disease in Down syndrome. However, the diagnostic delay, the detection of atypical symptoms or silent form in one third of the cases, and the increased incidence of autoimmune disorders suggest the need for the screening of celiac disease in all Down syndrome patients.
authors.affiliation: Department of Paediatrics, La Sapienza University, Rome, Italy. margherita.bonamico@uniroma1.it
authors.forename: M
authors.initials: M
authors.lastname: Bonamico
authors.forename: P
authors.initials: P
authors.lastname: Mariani
authors.forename: H M
authors.initials: HM
authors.lastname: Danesi
authors.forename: M
authors.initials: M
authors.lastname: Crisogianni
authors.forename: P
authors.initials: P
authors.lastname: Failla
authors.forename: G
authors.initials: G
authors.lastname: Gemme
authors.forename: A R
authors.initials: AR
authors.lastname: Quartino
authors.forename: A
authors.initials: A
authors.lastname: Giannotti
authors.forename: M
authors.initials: M
authors.lastname: Castro
authors.forename: F
authors.initials: F
authors.lastname: Balli
authors.forename: M
authors.initials: M
authors.lastname: Lecora
authors.forename: G
authors.initials: G
authors.lastname: Andria
authors.forename: G
authors.initials: G
authors.lastname: Guariso
authors.forename: O
authors.initials: O
authors.lastname: Gabrielli
authors.forename: C
authors.initials: C
authors.lastname: Catassi
authors.forename: R
authors.initials: R
authors.lastname: Lazzari
authors.forename: N A
authors.initials: NA
authors.lastname: Balocco
authors.forename: S
authors.initials: S
authors.lastname: De Virgiliis
authors.forename: F
authors.initials: F
authors.lastname: Culasso
authors.forename: C
authors.initials: C
authors.lastname: Romano
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D005903:Gliadin