Gastrointestinal findings in children with Down syndrome: Is there an early sign for Celiac disease?

Abstract

Aim: To investigate the prevalence of celiac disease (CD) among children with Down’s syndrome (DS) and its association with gastrointestinal symptoms and other accompanying diseases. Methods: The study was consisted of regular trisomy 21 patients who were under follow-up in our department. The age, gender, gastrointestinal symptoms (abdominal pain, constipation, diarrhea, abdominal distension, vomiting, flatulence, and unsatisfactory weight gain/weight loss) and accompanying diseases were recorded. Anti-tissue transglutaminase (anti-tTG) immunoglobulin A (Ig A) levels were analyzed in all cases. Serologically positive patients were referred to a pediatric gastroenterologist for intestinal biopsy. Results: Totally 98 children with a mean age of 3.2±2.81 years (range: 2-13 years) diagnosed with the DS were included in this study. Among study participants, 46 (46.9%) were female. Among study participants, 3 (3.1%) had positive anti-tTG IgA results and endoscopic biopsies revealed the diagnosis of Marsh type 3b CD in all of them. In correlation analysis, hypothyroidism (p=0.03) and presence of diarrhea (p=0.04) significantly correlated with the CD presence among children with the DS. Diarrhea increased the risk for 1.50 times (0.67-3.34) while hypothyroidism increased the risk for 2.75 times (0.55-13.67) among patients with DS. Conclusion: Clinicians should be aware of an increased prevalence of CD among patients with DS especially in children with diarrhea and/or hypothyroidism.