Diarrheal Versus Non-diarrheal Presentations of Paediatric Celiac Disease.

OBJECTIVE: To compare the frequencies and clinical features of diarrheal versus non-diarrheal presentation of celiac disease (CD). STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Paediatric Department, Benazir Bhutto Hospital, Rawalpindi, from January to December 2013. METHODOLOGY: Children with celiac disease, newly diagnosed on the basis of tissue transglutaminasel (TTG) and intestinal histopathology, were included in the study by consecutive non-probability sampling. Patients were divided into diarrheal and non-diarrheal groups on the basis of presence or absence of chronic or recurrent diarrhea. Comparison between two groups was done and a p-value < 0.05 was considered significant. RESULTS: Total patients were 54 (26 males, 28 females) with mean age of 6.67 ±3.35 years. Chronic diarrhea was present in 31 (57.4%) and absent in 23 (42.6%). Patients in non-diarrheal group were diagnosed at a significantly later age (p=0.038) and had a greater frequency of severe malnutrition (p=0.02). Short stature, anemia, rickets, clubbing and abdominal distension were equally prevalent. There was no significant difference in TTG value and intestinal histopathology among two groups. CONCLUSION: Children with atypical presentation of CD had significant severe malnutrition and higher age at diagnosis than at diarrheal presentation.