title: Presentation of pediatric celiac disease in the United States: prominent effect of breastfeeding.
abstract: 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.
authors.affiliation: Department of Medicine, and the Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: D'Amico
authors.forename: Jessica
authors.initials: J
authors.lastname: Holmes
authors.forename: Stavros N
authors.initials: SN
authors.lastname: Stavropoulos
authors.forename: Marisa
authors.initials: M
authors.lastname: Frederick
authors.forename: Joseph
authors.initials: J
authors.lastname: Levy
authors.forename: Amy R
authors.initials: AR
authors.lastname: DeFelice
authors.forename: Philip G
authors.initials: PG
authors.lastname: Kazlow
authors.forename: Peter H R
authors.initials: PH
authors.lastname: Green
mesh_terms: 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