title: Prevalence of Celiac Disease in Children with Unexplained Failure to Thrive.
abstract: BACKGROUND
  Gluten sensitive enteropathy or celiac disease (CD) is a disorder of small bowel that occurs upon exposure to gluten. A total of 67 children of either sex in the age group of 1-12 years with unexplained failure to thrive were studied for the prevalence of CD.
  
  
  METHODS
  This was a cross-sectional study. It included detailed history, clinical assessment, estimation of anti gliadin (AGA), tissue transglutaminase antibodies (tTGA) and duodenal biopsy. Treatment with gluten free diet and follow-up of diagnosed cases was done for one year.
  
  
  RESULTS
  Sixteen cases (23.88%) had villous atrophy and positive serology, essential criteria for the diagnosis of CD. Forty six (69%) children were between 4-12 years of age. Male to female ratio was 2.3:1. Main symptoms were irritability (63%), diarrhea (56%) and weight loss (56%). Thirty seven (56%) children had weight less than 3(rd) percentile. tTGA was 100% sensitive and 90.2% specific. Duodenal biopsy showed decreased villious-crypt ratio in 81.25% and intra epithelial lymphocytosis in 81% children (p<0.000001). All the confirmed cases were advised strict gluten free diet for one year. On follow-up at six months, all children showed improvement in their symptoms and weight gain.
  
  
  CONCLUSIONS
  CD is an important cause of unexplained failure to thrive in children.
authors.affiliation: Senior Advisor (Paediatrics and Paediatric Neurology), Army Hospital (R&R), Delhi Cant, New Delhi-10.
authors.forename: K S
authors.initials: KS
authors.lastname: Rana
authors.affiliation: Senior Advisor (Medicine and Gastroenterology), Army Hospital (R&R), Delhi Cant, New Delhi-10.
authors.forename: P
authors.initials: P
authors.lastname: Puri
authors.affiliation: Classified Specialist (Pathology and Nephropathology), 151 Base Hospital, C/o 99 APO.
authors.forename: S
authors.initials: S
authors.lastname: Badwal
keywords: Celiac disease; Failure to thrive