title: Celiac disease in a large cohort of children and adolescents with recurrent headache: A retrospective study.
abstract: BACKGROUND
  The clinical picture of celiac disease is changing with the emergence of subclinical forms and growing evidence reporting associated neurological disorders.
  
  
  OBJECTIVE
  To establish the prevalence of celiac disease in children suffering from recurrent headache.
  
  
  METHODS
  In our retrospective study we collected charts from 1131 children attending our tertiary care Centre for Paediatric Headache over the period 2001-2012. They were screened for celiac disease and positive patients were referred to our Operative Unit for Coeliac disease and confirmed positive children underwent upper endoscopy with multiple duodenal biopsies. Celiac children started a gluten-free diet.
  
  
  RESULTS
  883 children (481 females; median age, 9.8 years, range 3-19) performed celiac disease screening, and among them, 11 children (7 females; median age, 8.2 years, range: 4.8-13.9) were diagnosed with celiac disease. Seven children (5 females, median age, 11.9 years, range: 10.3-13.9) had been diagnosed as celiac prior to the neurological evaluation. The prevalence of celiac disease in our sample is 2.04% vs. 1.2% of the general population (p=0.034).
  
  
  CONCLUSIONS
  Our study demonstrates, on a large series, that celiac disease prevalence is doubled in patients with chronic headache. Screening for celiac disease could be advised as part of the diagnostic work-up in these paediatric patients, particularly among pharmacological non-responders.
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy. Electronic address: raffaella.nenna@uniroma1.it.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Nenna
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Petrarca
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Verdecchia
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Florio
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Pietropaoli
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gerarda
authors.initials: G
authors.lastname: Mastrogiorgio
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Bavastrelli
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Bonamico
authors.affiliation: Department of Paediatrics and Infant Neuropsychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D055050:Diet, Gluten-Free; D005260:Female; D020773:Headache Disorders / Q000178:diet therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
keywords: Anti-transglutaminase antibodies; Celiac disease; Gluten-free diet; Headache