Celiac disease in 87 children with typical and atypical symptoms in Black Sea region of Turkey.
BACKGROUND
Celiac disease presents with a spectrum of clinical disorders. The variety of clinical presentations largely depends on age and extraintestinal findings. This study aimed to determine typical and atypical cases according to presenting symptoms and to evaluate their biochemical and pathological parameters.


METHODS
Eighty-seven patients with celiac disease in our unit between 2000 and 2007 were reviewed. Their diagnosis was made by serological and histological examination. The patients were divided into two groups according to their typical or atypical symptoms.


RESULTS
The mean age of the patients at diagnosis was 8.2 years (range, 1-18 years), but patients presenting with typical symptoms were younger than those presenting with atypical symptoms. The patients in the two groups did not differ significantly in sex, weight and height Z scores except age. Diarrhea (96.3%), abdominal distention (65.4%) and failure to thrive (60%) were the most common clinical presentations in the typical group, and short stature (62.5%) and anemia (31.2%) were the most common in the atypical group. Total/subtotal villous atrophy was significantly higher in the typical group than in the atypical group.


CONCLUSIONS
Many children with celiac disease show an atypical form. The understanding of presentations of celiac disease may prevent delayed diagnosis. Celiac disease should be specially investigated in patients with recurrent iron deficiency anemia, short stature and autoimmune disorders.
Dinler
Gönül
G
Unit of Pediatric Gastroenterology Hepatology and Nutrition, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. gdinler@omu.edu.tr
Atalay
Erdal
E
Kalayci
Ayhan Gazi
AG
D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D005183:Failure to Thrive / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D014421:Turkey