title: Celiac disease presenting as rickets in Saudi children.
abstract: OBJECTIVE
  Rickets is commonly seen as a sign of malabsorption like celiac disease if it is not treated appropriately with vitamin D and calcium supplements. The aim of this study was to examine the frequency of diagnosis of celiac disease among children with unexplained rickets in Saudi children at a tertiary hospital setting.
  
  
  METHODS
  Retrospective review of records of patients referred over 10 years to a pediatric gastroenterology and hepatology unit.
  
  
  METHODS
  The study included all patients referred for evaluation of unexplained rickets and osteomalacia and screened for celiac disease. The diagnosis of rickets was made on the basis of history, physical examination, biochemical and radiological investigations. The diagnosis of celiac disease was made based on the ESPGHAN (European Society for Pediatric Gastroenterology, Hepatology, and Nutrition) criteria.
  
  
  RESULTS
  Twenty-six children with a mean (SD) age of 9.5 (4.6) years (5 males, range 1-15 years) were referred for evaluation of unexplained rickets and were screened for celiac disease. The diagnosis of celiac disease based on small bowel biopsy findings was confirmed in 10 (38.4%) patients with rickets. Serological markers for celiac disease including antiendomyseal antibodies and antitissue transglutaminase antibodies were positive in all ten children.
  
  
  CONCLUSIONS
  Rickets is not an uncommon presentation of celiac disease in Saudi children and pediatricians should consider celiac disease as an underlying cause for rickets.
authors: Department of Pediatric, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors: Asaad
authors: A
authors: Assiri
authors: Anjum
authors: A
authors: Saeed
authors: Ahmed
authors: A
authors: AlSarkhy
authors: Mohammed Issa
authors: MI
authors: El Mouzan
authors: Wael
authors: W
authors: El Matary
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005176:Factor XIII / Q000032:analysis; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012279:Rickets / Q000175:diagnosis / Q000209:etiology*; D012529:Saudi Arabia; D011503:Transglutaminases / Q000032:analysis / Q000276:immunology; D014807:Vitamin D / Q000097:blood*
chemical_list: D001323:Autoantibodies; D014807:Vitamin D; D005176:Factor XIII; D011503:Transglutaminases