Publication:

Celiac disease in children with failure to thrive and our experience in a tertiary care hospital of Kashmir in north India

Background Celiac disease (CD) is an autoimmune gastrointestinal disease caused by intolerance to gluten. Celiac disease is an important cause of failure to thrive in children. In addition to intestinal and extra intestinal clinical features, the diagnosis of CD is based up on histological findings in duodenal or jejunal biopsies, which may present in various forms.

Methods The study was a prospective observational, cohort study, including all children between 2-18 yrs. of age presented with failure to thrive fulfilling criterias of study. The patients with increased levels of IgA anti tTGA were selected for upper gastrointestinal endoscopy and duodenal biopsy. The aim of study is to study the prevalence and clinical profile of CD in children with failure to thrive.

Results A total of 66 cases of failure to thrive/short stature were enrolled, with prevalence of 24.2% of CD.  Male: Female ratio was 1:1 in children with CD. Clinical features include weight loss (62.5%), irritability (37.5%), anemia (37.5%), diarrhea (37.5%). On biopsy cases 87.5% cases of failure to thrive had Marsh grading of grade 3 and 12.5% had Marsh grade 2.

Conclusions Failure to thrive patients with diarrhea and anemia should be evaluated upfront for celiac disease.