CELIAC-DISEASE IN ARABS

A systematic study of celiac disease in a defined population of Arab c hildren has not been previously reported. We therefore performed a pro spective study to determine the incidence and clinical presentation of celiac disease in Jordanian children. A total of 34 (12 boys and 22 g irls) cases were diagnosed over a period of 36 months. Nine cases were clustered in three families. The incidence was calculated to be 1:2,8 00 live births. The mean age at presentation was 4.6 years (range 0.3- 13), but it was 8.4 years at the time of diagnosis. Diarrhea was the m ain initial symptom in 15 (44%) patients. Other signs and symptoms inc luded recurrent abdominal pain in five patients (14%), short stature i n four (12%), abdominal distension in three (9%), constipation in thre e (9%), pallor and recurrent mouth ulcers in two patients each. At the time of diagnosis, 24 (71%) had hypochromic microcytic anemia, and ni ne (26%) had rickets. The relatively high incidence of celiac disease may be related to the large wheat consumption in this population (135 kg/head/year), and the late onset could be related to the widespread p revalence of prolonged breast-feeding in Jordan (12 months) and late i ntroduction of cereals (6.2 months) in children with late presentation . The delay in diagnosis might be due to the presence of other disease s clinically resembling celiac disease in our community.