Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2009, vol. 18, nr 2, March-April, p. 153–158

Publication type: original article

Language: English

Clinical Differences of Celiac Disease in Schoolchildren and Adult

Odrębności kliniczne choroby trzewnej ujawniającej się u dzieci w wieku szkolnym i u pacjentów dorosłych

Barbara Iwańczak1,, Krystyna Mowszet1,, Ewa Waszczuk2,, Agata Szlachcic1,, Leszek Paradowski2,

1 Second Department of Pediatrics, Gastroenterology, and Nutrition, Wroclaw Medical University, Poland

2 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

Abstract

Background. In recent decades an increase in newly diagnosed celiac disease in both schoolchildren and adults has been observed. Celiac disease is the most common genetically determined disease of the gastrointestinal system and is most frequently diagnosed in the first three years of life and between the ages of 44 and 64. Asymptomatic, silent, and late−onset celiac disease are the predominant forms.
Objectives. Analysis of the frequency of clinical symptoms and coexisting diseases in schoolchildren and adults with diagnosed celiac disease.
Material and Methods. The study comprised 59 children aged 7 to 18 years (mean: 12.5 years) and 52 adults aged 19 to 75 years (mean: 32 years) in whom celiac disease was diagnosed based on histological study of intestinal specimens and positive serologic tests (EmA, tTG). Clinical symptoms, nutritional status, and coexisting diseases were analyzed in all the patients.
Results. Low body mass (69.5%), abdominalgia (59.3%), recurrent diarrhea (39%), and anemia (28.8%) were most frequently observed in the children. The most frequent symptoms in the adults were anemia (80.7%), flatulence (76.9%), increased aminotransferase activity (AST and ALT, 73.1%), chronic diarrhea (59.6%), and low body mass (59.6%).
Conclusion. Deficiency in body mass and height as well as abdominal pains and recurrent diarrhea were the most frequent symptoms in the schoolchildren with celiac disease. In adults the most frequently observed were anemia, chronic diarrhea, flatulence, and increased AST and ALT activity as well as more frequent occurrence of diabetes mellitus, diseases of the thyroid gland, and osteoporosis.

Streszczenie

Wprowadzenie. W ostatnich dekadach zaobserwowano wzrost liczby rozpoznań choroby trzewnej u dzieci i dorosłych. Chorobę trzewną najczęściej rozpoznaje się w pierwszych trzech latach życia oraz w wieku 44–64 lat. W obrazie klinicznym choroby przeważają postacie skąpoobjawowe lub ukryte (silent celiac disease) oraz późno ujawniające się (late−onset celiac disease).
Cel pracy. Ocena porównawcza częstości występowania objawów chorobowych oraz chorób współistniejących u dzieci w wieku szkolnym i u dorosłych z rozpoznaną chorobą trzewną.
Materiał i metody. Analizą objęto 59 dzieci w wieku od 7 do 18 lat (średni wiek 12,5 lat) oraz 52 pacjentów dorosłych w wieku od 19 do 75 lat (średni wiek 32 lata), u których na podstawie wyniku badania histopatologicznego wycinków błony śluzowej jelita cienkiego oraz dodatnich testów serologicznych (tTG, EmA) rozpoznano chorobę trzewną. U pacjentów analizowano objawy chorobowe i stan odżywienia oraz choroby współistniejące.
Wyniki. U dzieci najczęściej obserwowano niedobór masy ciała i/lub wzrostu (69,5%), bóle brzucha (59,3%), nawracające biegunki (39%), niedokrwistość (28,8%). U pacjentów dorosłych najczęściej obserwowano niedokrwistość (80,7%), wzdęcia brzucha (76,9%), wzrost aktywności aminotransferaz AspAT, ALAT (73,1%), przewlekłe biegunki (59,6%) oraz niedobór masy ciała (59,6%).
Wnioski. Najczęstszymi objawami choroby trzewnej u dzieci w wieku szkolnym był niedobór masy ciała i wzrostu, bóle brzucha i nawracające biegunki. U pacjentów dorosłych najczęściej obserwowano: niedokrwistość, przewlekłą biegunkę, wzdęcia brzucha i wzrost aktywności AspA, ALAT oraz częstsze występowanie cukrzycy, chorób tarczycy i osteoporozy.

Key words

celiac disease, children, adults, clinical differences

Słowa kluczowe

dzieci, dorośli, odrębności kliniczne, choroba trzewna

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