CORRELATION OF CLINICAL CHARACTERISTICS AND SMALL-BOWEL HISTOPATHOLOGY IN CELIAC-DISEASE

Background: Literature information regarding clinical and histological correlates in celiac disease is limited. The present study was design ed to assess the value of various clinical parameters in predicting th e severity of small bowel histopathology. Methods: Small bowel biopsy specimens of 59 children with established celiac disease (ESPGAN crite ria) were evaluated blindly. Morphology was evaluated based on a commo n histopathology score. The following clinical variables were evaluate d: age at diagnosis, duration of symptoms, severity score of clinical symptoms, severity score of physical signs, and growth parameters (hei ght and weight Z scores). Multiple regression analysis was performed t o evaluate the relative importance of each clinical parameter. Results : Only three clinical variables revealed a significant correlation wit h the histopathology score. The symptom severity score (t=3.883, p=0.0 003) demonstrated a positive correlation. The two others, age at diagn osis (t=3.076, p = 0.0032) and duration of symptoms (t = -2.987, p = 0 .0041), revealed a negative correlation. Conclusions: We conclude that more severe clinical symptoms of a shorter duration, presented at a y ounger age, are better predictors of a more severe form of small bowel histopathology in children with celiac disease.