Abstract:
Objective To determine the clinical presentation of celiac disease and its crisis in children. Patients and Methods This prospective descriptive study was carried out at Department of Pediatrics, Shaheed Mohtrama Benazir Bhutto Medical University at Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan. Seventy children who were clinically suspected and had serological evidence in the form of positive t TGIgA were enrolled in the study. A pro forma was filled to record family history, feeding and weaning, clinical presentation, anthropometric measurements and laboratory investigations. The diagnosis of celiac disease was made on the basis of the clinical presentation, serological and histological features. Results Out of 70 children, 50 (71.4%) were female and 20 (28.5%) male with female to male ratio of 2.5:1. Age ranged from 1-12 years (mean age 7.11) and 50% were in age group of 5-9 years. The SD scoring revealed moderate degree of malnutrition -2 SD in 20 (28.5%) of children, severe malnutrition 3 SD in 35 (50%) of children and very severe malnutrition -4 SD in 15 (21.4%) of children. Sixty five (92.8%) children were exclusively breast feed till 2-4 months of age and later added buffalo milk as supplement. Weaning was started at age of 3-5 month, like biscuit, cereal, piece of rotti (bread). All patients had diarrhea, and 25 (35.7%) were treated for tuberculosis. Sixty (85.7%) cases have classical sign and symptoms of celiac disease and 14.3% had celiac crisis at presentation. The biopsy revealed M type 2 histopathology in 45 (64.3%) and M type 3 in 25 (35.7%) of cases. All cases recovered and improved on follow-up after gluten free diet. Conclusion Celiac disease presented with classical symptoms and signs in majority of children and its crisis were characterized by severe diarrhea and dehydration, unable to hold neck, very severe malnutrition, edema, and calcium deficiency signs. Majority of patients were the product of consanguineous marriages and early introduction of gluten containing diet.
Page(s):
235-238
DOI:
DOI not available
Published:
Journal: Rawal Medical Journal, Volume: 37, Issue: 3, Year: 2012