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Clinical manifestation of celiac disease diagnosed in children of 4 years and above in self-study --- Obraz kliniczny celiakii rozpoznanej po 4 roku zycia w materiale wlasnym Kliniki Alergologii, Gastroenterologii i Zywienia Dzieci Uniwersytetu Medycznego w Lodzi

Author(s): Magdalena Kostrzewska | Ewa Toporowska-Kowalska | Joanna Kudzin | Krystyna Wssowska-Krolikowska

Journal: Przegląd Pediatryczny
ISSN 0137-723X

Volume: 37;
Issue: 2;
Start page: 237;
Date: 2007;
Original page

Background: Changing clinical manifestation of celiac disease could be the cause of diagnostic difficulties and recognition de- lay. The aim of the study is evaluation of clinical manifestation of celiac disease in children of 4 years and above in Children's Aler- gology, Gastrenterology and Nutrition Department of Medical University, Lods, in self-study in 2004-2006. Material and methods: Analysis of celiac clinical symptoms in a group of 17 children (11 girls/6 boys; average 11.12+/-4.67years), recognized >4 years old. Celiac disease was defined as classical (CK) and atypical (CA). Results: CK was found in 8 children (4 girls/4 boys; average 12.06+/-5.06years), CAin 9 (7 girls/2 boys; average 10.28+/-4.42 years). In the CK group 3 cases of full-symptom celiac disease were recognized (z-score BMI -0.89+/-0.07, anaemia, behavior disorders); in others (z-score BMI 0.24+/-0.39) diarrhoeas and abdominal pains were dominating. In anamnesis in children with CK anaemia resistant to treatment (n=3) and malabsorption (n=3) were found. In CA group in 6/9 children (z-score BMI -0.53+/-1.21) celiac disease diagnosis was preceded by other autoimmunologic disorders (juvenile chronic arthritis - JCA, type 1 diabetes mellitus - T1DM, T1DM and Graves-Basedov disease). Out of them in 2 patients height deficiency, in 3 recurrent abdominal pain and in 1 periodic diarrhea were observed. Three more children with undernutrition (z-score BMI -2.09+/-0.85, anaemia, trophical changes in oral cavity, enamel hypoplasia) and behavior disorders (2/3) were also classified into CA group despite their parents negation of gastrointestinal symptoms. Conclusion: 1. Clinical manifestation of celiac disease diagnosed in children 4 years and above could be variable and differentiation between latent and late-diagnosed form, sometimes difficult. 2. In children with autoimmunological disorders and positive serological screening into celiac disease, full diagnostics is needed, despite the lack of evident celiac disease symptoms.
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