Muhammad Asim Ikram, Aisha Sajid, Sadia Hameed, Kashan Arshad, Irshad -ul- Haq


Background: Coeliac disease used to be considered as a disease of European and Western population
but now it has emerged as a global problem. Objective of this study was to evaluate the frequency and
mode of presentation of coeliac disease in children presenting with failure to thrive. Methods: This
cross-sectional descriptive study was conducted at Paediatrics Department of Madina Teaching
Hospital in collaboration with Histopathology Department of University Medical and Dental College,
Faisalabad over a period from April 2010 to March 2011. A total of 60 children, aged 4–6 years
presenting as failure to thrive according to their height and weight, were included. Relevant
investigations were done along with radiological assessment of bone age. The jejunal biopsy was taken
in all the patients. Children who were suffering from primary or secondary malnutrition due to other
chronic illnesses and malabsorptive syndromes were excluded from the study. The data was analysed
using SPSS-17. Chi-square test was used and p<0.05 was considered significant. Results: Total 60
children, 4–16 years of age were included in the study. Twenty-four (40%) children were diagnosed as
coeliac disease by jejunal biopsy showing Marsh Grade-3. Male/female ration was 1.5:1. The most
frequent symptom among these coeliac patients was abdominal distension (75%, p=0.041), followed by
pallor. (71%, p=0.048). Anaemia (Hb<12 gm/dl) was found in all 24 patients. Conclusion: Coeliac
disease is increasingly being recognised as presenting with atypical presentation like short stature,
failure to thrive, unexplained anaemia, rickets, abdominal distension and abdominal pain.
Keywords: Coeliac disease, Failure to thrive, Mixed Deficiency Anaemia

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