TITLE:
Classical and Non-Classical Celiac Disease Comparison: Ten Years of Study
AUTHORS:
Katia Regina Pena Schesquini-Roriz, Jocelyn Cristina Betancourt Castellanos, Laura Martinez Martinez, Gloria Maria Fraga Rodriguez, Susana Boronat Guerrero, Isabel Badell Serra
KEYWORDS:
Celiac Disease, Gluten Allergy, Extra-Intestinal Manifestation, Disease Associated with Celiac Disease
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.2,
April
27,
2022
ABSTRACT: Objective: Celiac disease (CD) is an immune-mediated systemic disorder triggered by
gluten. It has a variable combination of clinical manifestations and changes that have been occurring in
recent decades however they are not known in detail. The purpose of the article
is to compare Classical and Non-Classical CD cases in terms of demographic
characteristics, duodenal biopsy, extraintestinal manifestations, and
associated comorbidities. Materials and Methods: A comparative
retrospective cohort study from January 2008 to December 2018. Results: A
total of 128 cases were included: 84 Classical (66%) and 44 Non-Classical CD
(34%). The family history of CD was identified in 14% of cases without
differences between groups. The age at diagnosis was distinct for Classical and
Non-Classical CD (4.9 ± 4 and 8.3 ± 4 years old; p 0.001),
respectively. Important changes were found within the classical presentation,
including mono symptoms
and a significantly higher rate of intestinal atrophy; p = 0.04. The
main Non-Classical CD symptom was recurrent abdominal pain. The extraintestinal
manifestations (EIM) were identified in 42% and occurred in both groups. The comparison between
groups showed differences in rates of migraine and vitamin D deficiency and was higher for Non-Classical CD
(p 0.05). Associated diseases
occurred in 10.9%, and type
1 diabetes was significant for the Non-Classical CD group (p = 0.04). Conclusion: The classical CD was the most prevalent profile and presented a decrease in
the severity of symptoms however remain a higher rate of intestinal atrophy.
Recurrent abdominal pain was the main symptom of Non-Classical CD.
Extraintestinal manifestations and associated diseases presented an increasing
trend of occurrence among cases of Non-Classical CD.