Clinical presentation of celiac disease among pediatric compared to adolescent and adult patients.
BACKGROUND
Celiac disease (CD) is being increasingly recognized in adults though a majority of patients continue to be diagnosed in childhood.


OBJECTIVE
To compare the clinical presentation and profile of newly diagnosed pediatric and adolescent/adult CD patients.


METHODS
Retrospective analysis of patients diagnosed with CD between year 1997 and 2007 in the pediatric group, and between year 2000 and 2007 in the adolescent/adult group was done for clinical presentation, endoscopic findings and duodenal histology.


RESULTS
A total of 434 children and 298 adults were studied. The mean age of diagnosis was 6.5 ± 2.5 years (1-11 years) in children and 29.3 ± 13.3 years (6-73 years) in adolescent/adults. The mean duration of symptoms before diagnosis was 3.5 ± 2.5 years in children and 4.9 ± 4.6 years in the latter. Diarrhea as the presenting symptom was seen in 74 % of children and 58.7 % of adolescent/adults. Anemia (on investigations) was seen in 84 % of children and 94 % of adolescent/adults.


CONCLUSIONS
Pediatric patients of CD present more often with typical features than adults. Atypical presentations are more common in adults and the latent period for diagnosis is also longer in adolescent/adults. There is a need for increasing awareness about CD, both among pediatricians and physicians caring for adult patients.
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India. dr_kochhar@hotmail.com
Rakesh
R
Kochhar
Kapil
K
Jain
Babu R
BR
Thapa
Pawan
P
Rawal
Abdul
A
Khaliq
Rashi
R
Kochhar
Sanjay
S
Bhadada
Kim
K
Vaiphei
Subhash
S
Varma
Usha
U
Dutta
Chander K
CK
Nain
Kaushal K
KK
Prasad
Kartar
K
Singh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology / Q000473:pathology; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D063128:Tertiary Health Care; D055815:Young Adult