Celiac Disease in Children with Severe Acute Malnutrition (SAM): A Hospital Based Study.
OBJECTIVE
To evaluate the prevalence and clinical features of Celiac disease among children with severe acute malnutrition (SAM).


METHODS
This prospective observational study was conducted in PBM Children Hospital, Bikaner from July 2012 through December 2013. All consecutively admitted children with SAM were recruited. All subjects were screened for Celiac disease by serological test for IgA-anti tissue Transglutaminase (IgA tTG) antibodies. All seropositive children underwent upper gastrointestinal endoscopy for small bowel biopsy for the confirmation. Clinical features of patients with and without celiac disease were compared.


RESULTS
The sero-prevalence (IgA tTg positivity) of Celiac disease was found to be 15.38% while prevalence of biopsy confirmed Celiac disease was 14.42% among SAM children. Abdominal distension, diarrhea, anorexia, constipation, pain in abdomen, vitamin deficiencies, edema, clubbing and mouth ulcers were more common in patients of Celiac disease compared to patients without Celiac disease but the difference was statistically significant only for abdominal distension and pain abdomen.


CONCLUSIONS
There is a high prevalence of Celiac disease in SAM. Screening for Celiac disease (especially in presence of pain abdomen and abdominal distension) should be an essential part of work-up in all children with SAM.
Department of Pediatrics, Geetanjali Medical College, Udaipur, Rajasthan, 313002, India. neetu.beni@gmail.com.
Neetu
N
Beniwal
Department of Pediatrics, Geetanjali Medical College, Udaipur, Rajasthan, 313002, India.
Gaurav
G
Ameta
Department of Pediatrics, S P Medical College, Bikaner, Rajasthan, India.
Chandra Kumar
CK
Chahar
D000208:Acute Disease; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000150:complications*; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011446:Prospective Studies
Celiac disease; IgA-anti tissue transglutaminase antibodies; Screening; Severe acute malnutrition