Celiac Disease Case Finding Strategy in Romanian Symptomatic Children

Abstract

Objectives. Pediatricians face various challenges in different stages of celiac disease (CD) diagnosis. Whom to test is intensely debated because of CD's heterogenous clinical spectrum. The main purpose of the study was to identify symptoms or symptom associations that should initiate an active strategy of CD early diagnosis in Romanian children. Material and method. We conducted a prospective study in "Grigore Alexandrescu" Emergency Children's Hospital. From March 2013 until February 2014, 249 children with symptoms/signs at risk of CD were included. Results. CD was diagnosed in 11 (1/21 patients evaluated). One in 12.6; 16; 18; 18.5 and 18.5 children respectively with chronic diarrhea, low stature, growth failure, recurrent abdominal pain and constipation had CD. Certain symptom associations increased the risk: classical symptom associations (chronic diarrhea and weight loss), as well as other associations: recurrent abdominal pain and weight loss, constipation and weight loss, constipation and refractory iron deficiency anemia. Conclusion. Active screening among patients with symptoms and especially symptom associations at risk of CD would improve diagnosis rates in pediatric CD.