Clinical features of children with screening-identified evidence of celiac disease.
OBJECTIVE
At-risk groups commonly undergo screening for autoantibodies associated with celiac disease (CD). However, the clinical significance of a positive test remains uncertain. The objective of this study was to evaluate growth and clinical features of children who test positive for an autoantibody associated with CD.


METHODS
A case-control study of Denver area healthy infants and young children with and without CD autoantibodies was conducted. A cohort of HLA-characterized children were followed prospectively since birth for the development of immunoglobulin A antitissue transglutaminase autoantibodies (TG). Clinical evaluation, questionnaire, blood draw, and small bowel biopsy were performed. Growth and nutrition and frequency of positive responses were measured.


RESULTS
Compared with 100 age- and gender-matched TG-negative controls, 18 TG-positive children, 5.5 +/- 0.5 years of age, had a greater number of symptoms and lower z scores for weight-for-height and for body mass index. Responses that were independently associated with TG-positive status were irritability/lethargy, abdominal distention/gas, and difficulty with weight gain.


CONCLUSIONS
Screening-identified TG-positive children demonstrate mild alterations in growth and nutrition and report more symptoms than control subjects. Additional study is needed on the benefit and risk of identifying CD in at-risk groups.
Hoffenberg
Edward J
EJ
Department of Pediatrics, Children's Hospital, and the University of Colorado School of Medicine, Denver, Colorado, USA. hoffenberg.edward@tchden.org
Emery
Lisa M
LM
Barriga
Katherine J
KJ
Bao
Fei
F
Taylor
Jennifer
J
Eisenbarth
George S
GS
Haas
Joel E
JE
Sokol
Ronald J
RJ
Taki
Iman
I
Norris
Jill M
JM
Rewers
Marian
M
D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy; D015992:Body Mass Index; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis*; D002675:Child, Preschool; D006128:Growth; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007223:Infant; D008403:Mass Screening; D015596:Nutrition Assessment; D011503:Transglutaminases / Q000276:immunology
D001323:Autoantibodies; D007070:Immunoglobulin A; D011503:Transglutaminases