Celiac disease in children and adolescents at a singe center in Saudi Arabia.
OBJECTIVE
Celiac disease (CD) is an immune-mediated enteropathy, induced by gluten in genetically susceptible individuals. The objective of this study was to describe the clinical pattern of CD in children from the western region of Saudi Arabia.


METHODS
Retrospective, hospital-based.


METHODS
This study included children with a biopsy-proven diagnosis of CD made between September 2002 and July 2007. Children were admitted to the endoscopy unit for a small-bowel biopsy if they had gastrointestinal symptoms suggestive of CD or if they were positive for a CD-antibody screen performed for the high-risk groups.


RESULTS
Eighty children were identified with a diagnosis of CD. Their mean (SD) age was 9.6 (4.9) years (range, 0.5-18 years). There were 44 (55%) female patients. Forty-one (51%) patients were detected during screening of high-risk groups, while 39 (49%) patients had classical symptoms of malabsorption. The screening also detected asymptomatic patients. Of 65 patients tested, 11 (17%) had elevated liver function tests, which reverted to normal after introduction of a gluten-free diet (GFD) except in one case. Seventy-three (91%) patients were positive for anti-tissue transglutaminase antibodies, 18 (23%), for IgG anti-gliadin antibodies; and 46 (58%), for IgA anti-gliadin antibodies. Forty-one (56%) patients showed good adherence to GFD as assessed by dietary history and the decline in anti-tTG level.


CONCLUSIONS
CD may present with classical symptoms or be identified through screening programs. Growth and laboratory abnormalities usually improve after introduction of a GFD. Adherence to a GFD remains a problem; therefore, thorough assessment and counseling at the time of diagnosis and ongoing care are crucial.
Department of Pediatrics, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Omar I
OI
Saadah
D000293:Adolescent; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002118:Calcium / Q000097:blood; D002446:Celiac Disease / Q000178:diet therapy* / Q000276:immunology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D005260:Female; D005903:Gliadin / Q000276:immunology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007223:Infant; D008297:Male; D010349:Patient Compliance; D012189:Retrospective Studies; D012529:Saudi Arabia; D012699:Serology; D012709:Serum Albumin; D012885:Skinfold Thickness; D011503:Transglutaminases / Q000276:immunology
D006454:Hemoglobins; D007070:Immunoglobulin A; D012709:Serum Albumin; D005903:Gliadin; D011503:Transglutaminases; D002118:Calcium
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