title: Diarrheal Versus Non-diarrheal Presentations of Paediatric Celiac Disease.
abstract: OBJECTIVE
  To compare the frequencies and clinical features of diarrheal versus non-diarrheal presentation of celiac disease (CD).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Paediatric Department, Benazir Bhutto Hospital, Rawalpindi, from January to December 2013.
  
  
  METHODS
  Children with celiac disease, newly diagnosed on the basis of tissue transglutaminasel (TTG) and intestinal histopathology, were included in the study by consecutive non-probability sampling. Patients were divided into diarrheal and non-diarrheal groups on the basis of presence or absence of chronic or recurrent diarrhea. Comparison between two groups was done and a p-value < 0.05 was considered significant.
  
  
  RESULTS
  Total patients were 54 (26 males, 28 females) with mean age of 6.67 ±3.35 years. Chronic diarrhea was present in 31 (57.4%) and absent in 23 (42.6%). Patients in non-diarrheal group were diagnosed at a significantly later age (p=0.038) and had a greater frequency of severe malnutrition (p=0.02). Short stature, anemia, rickets, clubbing and abdominal distension were equally prevalent. There was no significant difference in TTG value and intestinal histopathology among two groups.
  
  
  CONCLUSIONS
  Children with atypical presentation of CD had significant severe malnutrition and higher age at diagnosis than at diarrheal presentation.
authors.affiliation: Department of Paediatrics Gastroenterology, The Children's Hospital and The Institute of Child Health, Lahore.
authors.forename: Muhammad Almas
authors.initials: MA
authors.lastname: Hashmi
authors.affiliation: Department of Medicine, Benazir Bhutto Hospital, Rawalpindi.
authors.forename: Tanveer
authors.initials: T
authors.lastname: Hussain
authors.affiliation: Department of Paediatrics, Benazir Bhutto Hospital, Rawalpindi.
authors.forename: Najaf
authors.initials: N
authors.lastname: Masood
authors.affiliation: Department of Paediatrics, Benazir Bhutto Hospital, Rawalpindi.
authors.forename: Rai Muhammad
authors.initials: RM
authors.lastname: Asghar
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000740:Anemia / Q000209:etiology; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D013163:Splenomegaly / Q000209:etiology; D011503:Transglutaminases / Q000097:blood / Q000276:immunology*
chemical_list: D007070:Immunoglobulin A; D011503:Transglutaminases