A Review of Pediatric Celiac Patients in Southeastern Turkey: A Single-Center Experience

Abstract

Objective: Celiac disease is an autoimmune enteropathy that primarily affects the small intestine. Celiac disease occurs with \rthe ingestion of foods containing gluten and is characterized by malabsorption in individuals with a genetic predisposition. \rThis study aimed to review the clinical, laboratory, radiological, and pathological findings of pediatric celiac patients who were \rfollowed in our clinic and to compare the data with previous reports in the literature.\rMethods: A total of 509 patients who were diagnosed with celiac disease in the Pediatric Gastroenterology Clinic between \r2010 and 2013 were included in this study. Medical records of the patients were reviewed retrospectively to collect their demographic characteristics, anthropometric and bone mineral density measurements, laboratory results, radiological imaging, \rendoscopic examinations, and pathology reports of the biopsy materials.\rResults: Of the 509 patients enrolled in the study, 290 (57%) were females and 219 (43%) males. Among these patients, 441 \r(86.6%) presented with typical symptoms and 68 (13.4%) presented with atypical symptoms. A total of 479 (94.1%) patients \rwere compliant with the gluten-free diet, whereas 30 (5.9%) patients were not. The chief complaint was growth retardation \rin the patient groups aged 61 to 144 months (44.6%) and >145 months (59%) and diarrhea (26.1%) in the patient group aged \r0-60 months. In all patients, the most common physical examination findings at the time of presentation were normal (57.4%), \rand the most common comorbidities were iron deficiency anemia (35%) and osteoporosis (33%). While Marsh-Oberhuber stage \r3c (52.5%) was most common in patients aged 0-60 months, Marsh-Oberhuber stage 3b was most common in patients aged \r61-144 months and patients aged >145 months (51.9% and 63.8%, respectively).\rConclusions: Although growth and developmental retardation and chronic diarrhea are cautionary for celiac disease, patients \rmay also present with extra-gastrointestinal (atypical) findings. The mainstay of celiac disease treatment is strict compliance \rwith a gluten-free diet. Reviewing a relatively large number of cases, this study sheds some light on the current status of pediatric celiac disease patients in the southeastern part of Turkey.