Rana K S, Puri P, Badwal S
Senior Advisor (Paediatrics and Paediatric Neurology), Army Hospital (R&R), Delhi Cant, New Delhi-10.
Senior Advisor (Medicine and Gastroenterology), Army Hospital (R&R), Delhi Cant, New Delhi-10.
Med J Armed Forces India. 2010 Apr;66(2):134-7. doi: 10.1016/S0377-1237(10)80125-X. Epub 2011 Jul 21.
Gluten sensitive enteropathy or celiac disease (CD) is a disorder of small bowel that occurs upon exposure to gluten. A total of 67 children of either sex in the age group of 1-12 years with unexplained failure to thrive were studied for the prevalence of CD.
This was a cross-sectional study. It included detailed history, clinical assessment, estimation of anti gliadin (AGA), tissue transglutaminase antibodies (tTGA) and duodenal biopsy. Treatment with gluten free diet and follow-up of diagnosed cases was done for one year.
Sixteen cases (23.88%) had villous atrophy and positive serology, essential criteria for the diagnosis of CD. Forty six (69%) children were between 4-12 years of age. Male to female ratio was 2.3:1. Main symptoms were irritability (63%), diarrhea (56%) and weight loss (56%). Thirty seven (56%) children had weight less than 3(rd) percentile. tTGA was 100% sensitive and 90.2% specific. Duodenal biopsy showed decreased villious-crypt ratio in 81.25% and intra epithelial lymphocytosis in 81% children (p<0.000001). All the confirmed cases were advised strict gluten free diet for one year. On follow-up at six months, all children showed improvement in their symptoms and weight gain.
CD is an important cause of unexplained failure to thrive in children.
麸质敏感性肠病或乳糜泻（CD）是一种小肠疾病，在接触麸质后发病。对67名年龄在1至12岁、原因不明的发育不良儿童进行了CD患病率研究。
这是一项横断面研究。研究内容包括详细病史、临床评估、抗麦醇溶蛋白（AGA）、组织转谷氨酰胺酶抗体（tTGA）检测以及十二指肠活检。对确诊病例采用无麸质饮食治疗并随访一年。
16例（23.88%）出现绒毛萎缩且血清学检查呈阳性，这是诊断CD的关键标准。46名（69%）儿童年龄在4至12岁之间。男女比例为2.3:1。主要症状为易怒（63%）、腹泻（56%）和体重减轻（56%）。37名（56%）儿童体重低于第3百分位数。tTGA的敏感性为100%，特异性为90.2%。十二指肠活检显示，81.25%的儿童绒毛隐窝比值降低，81%的儿童存在上皮内淋巴细胞增多（p<0.000001）。所有确诊病例均被建议严格遵循无麸质饮食一年。在六个月的随访中，所有儿童的症状均有改善且体重增加。
CD是儿童原因不明的发育不良的重要原因。
