Coeliac disease in Indian children: Assessment of clinical, nutritional and pathologic characteristics

Coeliac disease is an important cause of chronic diarrhoea, failure to thri ve, and anaemia in children. Little information on the disease is available in India. This study was undertaken to determine the prevalence, clinical, anthropometric and histological profiles of coeliac disease in patients at tending a tertiary referral centre in India. Coeliac disease was diagnosed in 42 (16.6%) of 246 children with chronic diarrhoea, failure to thrive, an d anaemia. The mean ages at onset of symptoms and at diagnosis were 2.4 (ra nge 0.5-10) years and 8.3 (range 3-14) years respectively, and a mean perio d of delay in diagnosis was 5.9 (range 1-13.5) years. Of the 42 cases, hist ory of failure to thrive was observed in 38 (90%), chronic diarrhoea in 37 (88%), and anaemia in 6 cases. Short stature, under-nutrition, anaemia, oed ema of feet, rickets, clubbing of fingers, features of vitamin A deficiency , and B-vitamin deficiency were found in 42, 26, 38, 9, 8, 6, 3, and 2 case s respectively. Onset of symptoms, such as, chronic diarrhoea and failure t o thrive, was earlier in children with subtotal villous atrophy than in tho se with partial villous atrophy (mean+/-SD; 2.00+/-1.46 years vs 3.30+/-2.7 2 years; p<0.05). Results of the study suggest that coeliac disease is not uncommon in Indian children. Coeliac disease should be considered in the di fferential diagnosis, particularly in children without any symptoms of diar rhoea.