Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
Acta Paediatr. 2010 Jul;99(7):1026-30. doi: 10.1111/j.1651-2227.2010.01740.x. Epub 2010 Feb 25.
To describe the clinical picture of patients with coeliac disease (CD) and the change in its presentation over the past decades.
Patients with CD were identified and clinical data collected from hospital records over a 6-year period (2000-2005).
Altogether 197 patients aged 0.6-15.9 (mean 7.2) years were identified. They were found amongst the child population served by the hospital, the mean number of children at age 0.5-16 years was 268 000 during 2000-2005. The presenting symptom amongst the youngest patients (<3 years) was chronic diarrhoea (in 67%), and amongst older patients, abdominal pain. At the time of diagnosis, growth was severely retarded (height <2 SD for age) in 6.6%; mean height was -0.06 SD and weight + 1% for height. After diet treatment for a mean of 6 months, both height and weight increased significantly. Anaemia and iron deficiency were present in 25% and 43% of patients respectively. Intraepithelial T-cell receptor gamma/delta cells were pathologic in all 150 specimens studied.
The presentation of CD depends on age. Even when we found six times more patients than during years 1976-1985 in the same hospital, published data on the prevalence of CD suggest that we found only a small minority of children with CD.
描述乳糜泻(CD)患者的临床特征及其在过去几十年中的表现变化。
通过医院病历记录,在 6 年期间(2000-2005 年)识别 CD 患者并收集临床数据。
共确定了 197 名年龄为 0.6-15.9 岁(平均 7.2 岁)的患者。这些患者来自医院服务的儿童人群,2000-2005 年期间,0.5-16 岁儿童的平均数量为 268000 人。在年龄最小的患者(<3 岁)中,首发症状为慢性腹泻(占 67%),而在年龄较大的患者中,首发症状为腹痛。在诊断时,6.6%的患者生长严重迟缓(身高低于年龄的 2 个标准差);平均身高为-0.06 个标准差,体重为身高的+1%。在进行平均 6 个月的饮食治疗后,身高和体重均显著增加。贫血和缺铁分别存在于 25%和 43%的患者中。在研究的 150 个标本中,所有患者的上皮内 T 细胞受体 γ/δ细胞均存在病理改变。
CD 的表现取决于年龄。即使在同一医院发现的患者数量是 1976-1985 年期间的 6 倍,但发表的 CD 患病率数据表明,我们仅发现了一小部分 CD 患儿。