Clinical, Paraclinical and Histological Considerations for Coeliac Disease in Children

Introduction: Coeliac disease is an autoimmune enteropathy caused by gluten intolerance in genetically susceptible people. Gluten is a protein found in food containing wheat, oat, barley, rye. It can start with typical (classical) gastro-intestinal symptoms, atypical symptoms or may be silent (asymptomatic).
bjectives: Evaluation of the anthropometric, clinical, paraclinical and histopatological data of children with coeliac disease hospitalised at the Pediatric Clinic I in Târgu Mureş.
Material and method: The work is based on a study conducted retrospectively during 2006-2010. From the total number of 10982 patients, 25 were admitted for malabsorption syndrome and 12 out of these, with coeliac disease. The diagnosis has been set according to anamnesis, clinical examination, serology tests, histopathological and immunohistochemical test.
Results: Eight children with coeliac disease were older than 2 years of age and 4 children younger than 2 years of age. Two-thirds of the patients showed classical symptoms and one-third an asymptomatic form. The IgA type endomysial antibodies (IgA EMA) were positive in all children. Histopathologic and immunohistochemical tests were carried out in 58.3% of the cases.
Conclusions: The classical symptoms were prevalent. Anemia, weight loss, diarrhoea and growth failure were the most frequent signs and symptoms. Type 3c according to histopathological modified Marsh-Oberhuber classification was present in the majority of the cases. Serological screening (IgA EMA) is recommended in children presenting with weight loss, ferriprive anemia that does not respond to oral iron therapy, and growth failure.