Symptoms and signs have changed in Swedish children with coeliac disease.
OBJECTIVE
To examine symptoms and signs in children with coeliac disease and determine whether the clinical picture at disease onset has changed as incidence of the disease has decreased in the last 10 years. This project was part of the ABIS study (All Babies in Southeast Sweden, born from October 1997 to October 1999).


METHODS
Eight paediatric departments in Southeast Sweden recorded all children with coeliac disease and registered symptoms according to a standard form. Data were obtained from 79 children with biopsy-confirmed coeliac disease, 43 contemporary controls, and 65 historic controls.


RESULTS
When compared with children with normal intestinal biopsies, children with coeliac disease more often had abdominal distension (odds ratio [OR] = 22.17; 95% confidence interval [CI] OR = 5.00-98.25), thin extremities (OR = 5.89; 95% CI OR = 2.09-16.55), irritability (OR = 6.50; 95% CI OR = 1.83-23.03), and tiredness (OR = 15.43; 95% CI OR = 2.00-119.16). When compared with coeliac children diagnosed at < or =2 years of age in Gothenburg between 1985 and 1989, when the incidence of coeliac disease was three times higher, ABIS patients aged < or =2 years at diagnosis had less often experienced diarrhoea (OR = 0.23; 95% CI OR = 0.12-0.65), suboptimal weight gain (OR = 0.02; 95% CI OR = 0.01-0.10), or suboptimal linear growth (OR = 0.14; 95% CI OR = 0.05-0.39).


CONCLUSIONS
This study indicates that, in parallel to changes in incidence, clinical features of coeliac disease in young children have changed during the last 10 years.
Ludvigsson
Jonas F
JF
Department of Paediatrics, Orebro University Hospital, Orebro, Sweden. jonasludvigsson@yahoo.com
Ansved
Pär
P
Fälth-Magnusson
Karin
K
Hammersjö
Jan-Ake
JA
Johansson
Calle
C
Edvardsson
Stig
S
Ljungkrantz
Magnus
M
Stenhammar
Lars
L
Ludvigsson
Johnny
J
D002446:Celiac Disease / Q000453:epidemiology* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012621:Seasons; D013548:Sweden / Q000453:epidemiology