Clinical and Laboratory Findings of Celiac Disease in Patients Referred to Children Medical Center (Tehran; Iran)

Classic form of Celiac disease is recognized with malabsorption symptoms after introducing gluten diet. However, due to wide spectrum of disease some cases would remain undiagnosed. The aim of this study was to determine the clinical and laboratory features of celiac disease in children with celiac disease. In this study, 43 children with symptoms such as chronic diarrhea, failure to thrive, anemia and short stature in children medical center were included (2004-2008). Diagnosis was based on biopsy results and serologic tests and clinical response to gluten free diet. Patients were divided into two groups: children older than 2 years and less than 2 years. Clinical, biopsy and laboratory findings and pathologic results were assessed and compared. The most common clinical findings in 43 patients were underweight in 37 cases (86%), chronic diarrhea in 32 cases (74.4 %), anemia and short stature in 30 cases (69.8%) and positive IgA anti-endomysium in 28 cases (65%). Biopsy of the small intestine revealed type I, II, III in 8 (18.6%), 7 (16.3%) and 28 (55%) respectively. There was statistically significant difference between children older than 2 years with less than 2 years. The older patients experienced more abdominal pain, short stature and Marsh III in intestinal biopsy. Children older than 2 years have shown statistically significant difference in abdominal pain, short stature and Marsh III. (p<0.001, p<0.001, p<0.05) Results showed that celiac disease may present with different clinical presentation. Abdominal pain, short stature and Marsh III can be seen in children older than 2 years old compare to less which shows unusual presentation of disease in higher age. Information about these cases would help in better diagnosis.