Polymorphism of the Clinical Signs of Celiac Disease in Children

Celiac disease (CD) is an autoimmune systemic condition caused by sensitivity to gluten in genetically predisposed patients. The clinical signs of CD are extremely diverse, ranging from the typical intestinal malabsorption syndrome (characterized by chronic diarrhea, abdominal distension and malnutrition) to atypical symptoms that may involve any system or organ: chronic constipation, increased level of liver enzymes, iron deficiency anemia, recurrent abdominal pain, neurological conditions, tooth enamel erosion. The authors report four pediatric cases diagnosed with various atypical forms of celiac disease: the form associated with recurrent abdominal pain and increased level of liver enzymes, and the form associated with chronic constipation, all accompanied by failure to thrive and one case of type I diabetes mellitus associated with celiac disease. To conclude with, pediatricians, gastroenterologists and general practitioners should be familiar with all the clinical forms of coeliac disease in order to be able to diagnose this childhood disease and thus prevent long-term complications like osteoporosis, infertility and intestinal lymphoma.