Is clinical spectrum of celiac disease changing in children? Çocuklarda Çölyak Hastalığının Klinik Spektrumu Değişiyor mu?

Abstract

Copyright © 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Objective: Celiac disease (CD) is a leading cause of malabsorption in children and is known to have multiple manifestations. The frequency of diagnosis and the number of cases diagnosed based on atypical findings have recently increased due to the enhancement of serological tests, safe endoscopic environments, and the improved awareness of celiac disease among physicians. In the present study, we aimed to evaluate the clinical, laboratory, and histopathological findings of children with CD over time periods. Material and Methods: The age, gender, body weight and height, presenting symptoms, and laboratory and histopathological findings of patients who were diagnosed with CD in our clinic between 2008 and 2019, were evaluated. The patients were divided into two groups based on the year of diagnosis: Group 1, 2008-2014 and Group 2, 2015-2019. The presenting symptoms were also divided into typical and atypical symptoms. Results: The study included 148 patients (66.9% girls, mean age 7.12 ±4.24). Most common presenting symptom was chronic diarrhea (31.3%) in Group 1 and failure to thrive (35.7%) in Group 2 (p0.05). In nutritional state, the prevalence of underweight was higher in Group 2 (p<0.05). Of all patients, 14 (9.45%) patients had an accompanying autoimmune disease and the prevalence of these diseases was higher in Group 1 (15.62%). In histopathological evaluation, the patients in Group 2 had higher grades (p<0.05). Conclusion: The clinical spectrum of CD are likely to change over time. In recent years, patient with CD presented with failure to thrive commonly and associated autoimmune diseases are uncommon. Patients present with advanced histopathological grade.