title: Changing face and clinical features of celiac disease in children.
abstract: BACKGROUND
  The aim of this study was to analyze and compare the epidemiological and presenting features, clinical patterns, and complications of celiac disease (CD) in children.
  
  
  METHODS
  The clinical charts of children with CD were retrospectively analyzed. Data for children who presented during the first time period (January 2005-October 2008; group 1) were compared to those of children who presented during the second time period (November 2008-April 2012; group 2).
  
  
  RESULTS
  Group 1 and 2 consisted of 96 and 95 children, respectively. There were no differences in gender distribution, weight, or height z-scores between the two groups. Mean age at the time of diagnosis in group 2 (9.3 ± 4.5 years) was significantly higher than in group 1 (6.9 ± 3.9 years; P < 0.001). Non-classical presentation was more frequent in group 2 (P = 0.01). Associated disorders were observed in 49 children (25.7%) overall. There were significantly more children with type 1 diabetes mellitus in group 2 (P = 0.030). In all, 11 patients (5.8%) were overweight (either obese or at risk of obesity) at presentation. Isolated short stature was the presenting feature in 15 children (7.9%) overall, but was more frequently observed in group 2 (P = 0.003). In total, 15 patients (7.9%) presented with refractory iron deficiency anemia; the frequency was similar in both groups. Dual-energy X-ray absorptiometry was performed in 102 patients, and 82 (80.4%) had metabolic bone disease (MBD).
  
  
  CONCLUSIONS
  The mode of presentation and clinical features of CD in childhood continue to change. Of note, a substantial percentage of patients were overweight at presentation. MBD is a frequent complication, necessitating routine evaluation.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Gokce
authors.forename: Esra
authors.initials: E
authors.lastname: Arslantas
mesh_terms: D001835:Body Weight; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology
keywords: celiac; childhood; clinical manifestation; complication