Screening for Celiac Disease in Growth Retarded Children with or without Chronic Diarrhea: a Study on Children in Kerman/Iran

Background & Aims: The aim of this study was to determine the yield of screening for celiac disease in children with failure to thrive and with or without chronic diarrhea. Methods: In this prospective study, 144 children aged 1-14 years and weighed below the fifth percentile with or without chronic diarrhea were studied during six months in 2010. Sample collection was done in the private office of one of the researchers, health care clinics, schools, and subspecialty clinic of Afzalipour Hospital, Kerman/ Iran. Screening was done by measuring anti-tissue transglutaminase IgG antibody test (tTG test). All positive cases underwent upper endoscopy with pediatric Pentax video endoscope. Definitive diagnosis was made by doing small intestine biopsy and histological study. Results: Mean weight and age of children were respectively 14 ± 4.2kg and 6 ± 3.3 years. One third of subjects had diarrhea. Positive tTG test was observed in 11.1% of children. Celiac was confirmed in all seropositive subjects by intestinal biopsy. Therefore, the predictive value of tTG test was 100%. There was no significant relationship between the prevalence of celiac and variables of age (p=0.445), sex (p=0.859) and chronic diarrhea (p=0.137). Conclusion: Regarding the relatively high prevalence of celiac disease in growth retarded children (11.1%), and high sensitivity (100%) of tTG test found in the present study, screening of growth retarded children with or without chronic diarrhea for celiac disease seems logical.