Pooni Puneet Aulakh, Chhina Rajoo Singh, Jaina B K, Singh Daljit, Gautam Anil
Department of Pediatrics, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
J Trop Pediatr. 2006 Feb;52(1):30-3. doi: 10.1093/tropej/fmi054. Epub 2005 Jun 9.
This prospective study was carried out to evaluate the clinical and anthropometric profile of 71 children confirmed to have celiac disease on the basis of clinical features, duodenal biopsy and unequivocal improvement on gluten-free diet. Serological tests were performed in 35 cases. The patients were divided into three age groups <5 years, 5-10 years, and >10 years as per the age of presentation to the hospital. Mean age was 8.7 years with a slight female preponderance. Diarrhea was the commonest presentation in group I and failure to thrive in group III. All patients in group III, had weight for age (w/a) <3rd percentile and majority (83 per cent) had short stature, with delayed puberty in all. All children had significant improvement in symptoms and growth on gluten restriction. None of the patients had been suspected to have celiac disease before, which signifies that in spite of increasing incidence of celiac disease, this disease is grossly under-diagnosed in North India where wheat is the staple diet. It is essential to make an early diagnosis of celiac disease in children to prevent growth delay.
本前瞻性研究旨在评估71名经临床特征、十二指肠活检确诊为乳糜泻且采用无麸质饮食后明确改善的儿童的临床和人体测量学特征。对35例患者进行了血清学检测。根据患者到医院就诊时的年龄,将其分为三个年龄组:<5岁、5 - 10岁和>10岁。平均年龄为8.7岁,女性略占优势。腹泻是第一组最常见的表现,第三组则以生长发育迟缓为主。第三组所有患者的年龄别体重(w/a)均低于第3百分位,大多数(83%)身材矮小,且均有青春期延迟。所有儿童在限制麸质摄入后症状和生长情况均有显著改善。之前所有患者均未被怀疑患有乳糜泻,这表明尽管乳糜泻发病率不断上升,但在以小麦为主食的印度北部,这种疾病仍被严重漏诊。早期诊断儿童乳糜泻对于预防生长发育迟缓至关重要。