title: Differences between pediatric and adult celiac disease.
abstract: BACKGROUND
  Celiac disease (CD) is a common autoimmune condition (involves 1-2% of the general population) that develops at any age in life but manifests differently in children and adults.
  
  
  OBJECTIVE
  To analyze clinical differences in disease expression between both groups, as well as findings at the time of diagnosis.
  
  
  METHODS
  A retrospective study of a series of patients diagnosed with CD during childhood (< 14 years) versus a series of adult patients (> 14 years).
  
  
  RESULTS
  a total of 187 patients were included, of which 43 were children and 144 were adults. Among clinical manifestations in children classic presentation forms predominated -34 patients(79%) versus 20 adult patients (14%) (p < 0.001) (OR = 23.4;95% CI: 9.8-56.1). In contrast, atypical forms were predominant in the latter, and anemia was the most common finding in 61 patients (42%) versus 8 pediatric patients (19%) (p < 0.01). Adults had a greater diagnostic delay with a mean 10 ± 9 years versus 1 ± 2 years in children (p < 0.001). In adults, we found a higher frequency of associated autoimmune diseases (24.3 versus 9.3% in children) (p < 0.05). Regarding serum markers, TGt-2 was more commonly positive among children (88%) as compared to adults (31%) (p < 0.001); (OR = 21.4: 95% CI: 7.2-63.6). We found similar results with regard to the presence of villous atrophy, which was more common in children (95%) than in adults (33%) (p < 0.001) (OR = 41.0;95% CI: 9.5-76.7). As regards genetic markers, DQ2 was somewhat more common in children (97.7%) than in adults (90.3%) whereas DQ8 wasless common in children (2.3%) than in adults (9.7%), with no significant differences between groups. Patients negative for both markers were not included.
  
  
  CONCLUSIONS
  Pediatric CD has clear differences when compared to adult CD, with classic forms predominating in the former, who also display a higher occurrence of positive serology and villous atrophy, and less diagnostic delay. In contrast, atypical forms predominate in the adult, with a lower occurrence of positive serology and milder histological forms. In these patients associated autoimmune conditions are more common and diagnostic delay is longer.
authors: Department of Digestive Diseases, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. lrodrigosaez@gmail.com
authors: Luis
authors: L
authors: Rodrigo-Sáez
authors: Dolores
authors: D
authors: Fuentes-Álvarez
authors: Isabel
authors: I
authors: Pérez-Martínez
authors: Noemí
authors: N
authors: Alvarez-Mieres
authors: Pilar
authors: P
authors: Niño-García
authors: Ruth
authors: R
authors: de-Francisco-García
authors: Sabino
authors: S
authors: Riestra-Menéndez
authors: Carlos
authors: C
authors: Bousoño-García
authors: Rebeca
authors: R
authors: Alonso-Arias
authors: Antonio
authors: A
authors: López-Vázquez