Presentation of pediatric celiac disease in the United States: prominent effect of breastfeeding.
Childhood celiac disease (CD) is considered rare in the United States. Consequently there are few data concerning its clinical presentation. A validated questionnaire was distributed to families of children with CD. One hundred forty-one children with biopsy-proven CD were included in the study. We found significant differences in the clinical spectrum of children based on their infant feeding history. Exclusively breastfed children were significantly less likely to report failure to thrive (69% vs 88%, p<0.05) and short stature (37% vs 62%, p<0.05), and had a higher rate of "atypical'' symptoms (p<0.01). Breastfeeding alters the presentation and contributes to atypical presentations of CD and diagnostic delay. Pediatricians need to be aware of the diverse manifestations of celiac disease to reduce diagnostic delay.
D'Amico
Michael A
MA
Department of Medicine, and the Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Holmes
Jessica
J
Stavropoulos
Stavros N
SN
Frederick
Marisa
M
Levy
Joseph
J
DeFelice
Amy R
AR
Kazlow
Philip G
PG
Green
Peter H R
PH
D017677:Age Distribution; D001942:Breast Feeding; D002446:Celiac Disease / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food; D008297:Male; D015995:Prevalence; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology