The changing frequency of celiac disease diagnosed at the Stollery Children's Hospital
S Rajani | D Huynh | J Turner
BACKGROUND: Celiac disease (CD) is recognized as one of the
most common and important autoimmune gastrointestinal disorders
affecting children. There is evidence that a diagnosis of CD during
childhood improves health outcomes. The increasing prevalence of
CD is due to increased awareness of the wide range of extraintestinal
symptoms associated with CD.
OBJECTIVE: To determine whether there has been a temporal
increase in the diagnosis of CD associated with an increased diagnosis
of children without typical gastrointestinal symptoms at the Stollery
Children's Hospital (Edmonton, Alberta).
METHODS: Patients with biopsy-proven CD diagnosed at the
Stollery Children's Hospital from 1998 to 2007, were identified by
retrospective chart review. Baseline and follow-up data, including
demographics, symptoms, risk factors, anthropometrics and laboratory
investigations, were collected.
RESULTS: An increase in the frequency of diagnosis of CD was
noted during the study period, particularly from January 2003 onward.
Before January 2003, nine children were diagnosed with CD - all
with typical symptoms. Between January 2003 and January 2007,
inclusive, 149 children were diagnosed with CD, of whom 46% had
absent or atypical symptoms. At follow-up, 96% of patients reported
improved symptoms, including 53% of individuals who reported being
asymptomatic before diagnosis.
CONCLUSIONS: In the last four years of the period studied, the
number of children diagnosed with CD at Stollery Children's Hospital
increased 11-fold. Screening children at risk for CD, and those with
atypical presentations, contributed to the increased number of diagnoses.
Identification of CD and establishment of lifelong, dietary gluten
avoidance during childhood has important health benefits and should