Anti-endomysial and anti-gliadin antibodies in screening for coeliac disease in children at greater risk of developing coeliac disease

Aims. To determine the prevalence of coeliac disease in selected groups of children presenting to a paediatric department. Methods. Children presenting to the Paediatric Department at Christchurch H ospital were enrolled upon identification of one or more factors associated with increased risk of coeliac disease. All subjects were screened with an d-endomysial antibody and antigliadin antibody tests. Those children with p ositive tests underwent small bowel biopsy. Results. 36 of 153 children had abnormal antibody tests. Seven (4.5%) of 34 children who underwent small bowel biopsies were found to have histologica l findings consistent with coeliac disease. Five of these children had pres ented with symptoms not classically ascribed to coeliac disease (failure to gain weight or non-specific abdominal pain). Conclusions. The possibility of coeliac disease should be considered in chi ldren with atypical symptoms and the diagnosis excluded by appropriate test ing. Recognition of the variable presentations associated with coeliac dise ase in children is clinically relevant.