Salman Ali, Emran Roshan, Shahid Aziz, Ajab Khan.
Coeliac disease in Children - A hospital based study.
Pak Armed Forces Med J Jan ;52(1):5-8.

A study was carried out in the Paediatric Departments of Combined Military Hospital Lahore and Military Hospital Rawalpindi on the prevalence and clinicopathological aspects of coeliac disease in children. The study extended over a period of two years from September 1995 to August 1997. All children clinically suspected of having coeliac disease were examined and investigated thoroughly. Small intestinal biopsy was obtained in all the cases for histopathological examination. The revised diagnostic criteria of ESPGAN 1990 were followed for case definition. During the period of study 43 cases were confirmed as coeliac disease. The prevalence of coeliac disease in this hospital based population came out to be 0.18%. The ages of patients ranged from 1 to 13 years and the male to female ratio was 1.3:1. Most of the children were from the Punjab and a few belonged to NWFP and Azad Kashmir. The mean age of presentation was 6.1 years. The major clinical manifestations at presentation were chronic diarrhoea (95%), anaemia (81%), failure to thrive (79%), abdominal pain (63.3%) and distention (44%), behaviour changes (60%), pica (37%) and vomiting off and on (42%). The main laboratory findings included hypochromic microcytic anaemia (70%) and hypoalbumlnaemia (60%). The histopathological study of small intestinal biopsy specimens showed total villous atrophy in 60.5% and partial villous atrophy in 39.5% of the cases. Response to gluten free diet was observed in all the patients. The results of this study are largely in conformity with other national and international studies on the subject. The study highlights the importance of looking for coeliac disease in our paediatric population as a significant problem and underscores the major role of small intestinal biopsy in its diagnosis and management.

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