Presentation Patterns and Nutritional Impact of Coeliac Disease in New Zealand Children

Abstract

RESULTS:Over the study period, 110 children were diagnosed at mean age of 7.37 years. The most common presenting symptom was abdominal pain. Sixteen children were diagnosed following screening in high risk groups, with 14 being asymptomatic. Eighteen children were iron deficient and twelve vitamin D deficient. CONCLUSIONS: CD was diagnosed in children of all ages, with various presentation patterns. Micronutrient deficiencies were commonly seen at diagnosis. Ongoing assessment of patterns of CD in NZ children is required. INTRODUCTIONCoeliac disease (CD) is an autoimmune disease of the small bowel, triggered by dietary exposure to gluten in genetically susceptible individuals [1] . Ingestion of gluten provokes immune-mediated damage to the small intestinal mucosa. The optimal management of CD currently involves institution of a life-long gluten free diet (GFD) [2] . The features of CD can develop at any age whilst on a gluten containing diet [3] . CD can have variable presentations from gastrointestinal symptoms to non-specific symptoms such as headaches or lethargy [4][5][6] . In addition, many individuals are increasingly identified consequent to active screening in groups at higher risk of CD (such as those with positive family history or type 1 diabetes) and a number of these individuals may be asymptomatic at diagnosis [7] . CD appears to be increasing in prevalence in many countries around the world, including New Zealand [7] . A population-based study conducted in the Christchurch region of New Zealand in the last years of the 20 th century using electoral roll records, showed a prevalence of 1.2% [8] . A further study in the same region documented more individuals being diagnosed with CD each year [9] . Subsequently AIM:To evaluate the presentation patterns of a cohort of children diagnosed with coeliac disease at Christchurch Hospital, New Zealand. METHODS: Children aged 15 years or less diagnosed with CD (based upon standard histological criteria) over a five year period were identified retrospectively. Presenting symptoms, anthropometry, serology and micronutrients were reviewed.