Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2013 Sep-Oct;22(5):667-73.
Celiac disease is a frequent disease of the alimentary tract in children. Clinical presentation of the disease is variable and depends on type of the disease.
The aim of the study was an analysis of clinical findings, selected laboratory features and coexisting diseases in children and adolescents with celiac disease.
Material of the study comprised a series of 78 children aged 8 months - 13 years. Celiac disease was diagnosed basing on clinical symptoms, histological studies of intestinal specimens and positive serologic tests (EmA, TG2).
Classical celiac disease was diagnosed in 40 children (51.3%), atypical celiac disease in 26 children (33.3%) and silent celiac disease in 12 children (15.4%). The most frequent clinical symptoms of classical form of celiac disease were chronic diarrhea (90.0%), recurrent abdominal pain (70.0%), development retardation (65%), hypocholesterolemia (35.0%) and IgA deficiency (22.5%). In atypical form of the disease dominated the following symptoms: recurrent abdominal pain (76.9%), failure to thrive (38.4%), short stature (42.3%), anemia (15.3%), hypertransaminasemia (11.5%), food allergy (19.2%) and thyroid diseases (11.5%). In silent celiac disease hypercholesterolemia was present in 33.3%, hypertriglycerydemia in 16.6%, type 1 diabetes in 50%, and celiac disease in parents or siblings in 33.3%.
Classical celiac disease is the most frequently diagnosed clinical form of the disease. Silent celiac disease occurs frequently in children with type 1 diabetes mellitus whose parents or siblings have celiac disease. Frequent diagnosis of atypical and silent forms of celiac disease is an indication to serological examination in children with unclear clinical picture and genetic predisposition.
乳糜泻是儿童消化道的一种常见疾病。该疾病的临床表现具有变异性，取决于疾病的类型。
本研究旨在分析乳糜泻患儿的临床发现、选择的实验室特征和并存疾病。
研究材料包括 78 例年龄在 8 个月至 13 岁的儿童。乳糜泻的诊断基于临床症状、肠组织学研究和阳性血清学检测（EmA、TG2）。
经典乳糜泻诊断 40 例（51.3%），非典型乳糜泻 26 例（33.3%），无症状乳糜泻 12 例（15.4%）。经典乳糜泻最常见的临床症状为慢性腹泻（90.0%）、反复腹痛（70.0%）、发育迟缓（65%）、低胆固醇血症（35.0%）和 IgA 缺乏（22.5%）。在非典型疾病中，以下症状更为突出：反复腹痛（76.9%）、生长不良（38.4%）、身材矮小（42.3%）、贫血（15.3%）、高转氨酶血症（11.5%）、食物过敏（19.2%）和甲状腺疾病（11.5%）。在无症状乳糜泻中，高胆固醇血症占 33.3%，高三酰甘油血症占 16.6%，1 型糖尿病占 50%，父母或兄弟姐妹中有乳糜泻的占 33.3%。
经典乳糜泻是最常见的疾病临床诊断类型。无症状乳糜泻在患有 1 型糖尿病的儿童中经常发生，其父母或兄弟姐妹患有乳糜泻。在具有不明确临床表现和遗传易感性的儿童中，经常诊断出非典型和无症状乳糜泻，表明需要进行血清学检查。
