Mansour HH, Mohsen NA, El-Shabrawi MH, Awad SM, Abd El-Kareem D. Serologic, endoscopic and pathologic findings in pediatric celiac disease: A single center experience in a low/middle income country. World J Clin Pediatr 2022; 11(3): 295-306 [PMID: 35663003 DOI: 10.5409/wjcp.v11.i3.295]
Corresponding Author of This Article
Mortada HF El-Shabrawi, MD, Professor, Department of Pediatrics, Faculty of Medicine Kasr Al Ainy, Cairo University, 3 Nablos Street, Off Shehab Street, Mohandesseen, Cairo 12411, Egypt. melshabrawi@medicine.cu.edu.eg
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Clin Pediatr. May 9, 2022; 11(3): 295-306 Published online May 9, 2022. doi: 10.5409/wjcp.v11.i3.295
Table 1 Clinical presentation of typical and atypical celiac disease
Clinical presentations
Typical, n = 120
Atypical, n = 79
P value
n
%
n
%
Male
62
51.7
41
51.9
0.974
Female
58
48.3
38
48.1
Chronic diarrhea
119
99.2
1
1.3
< 0.001
Abdominal distention
83
69.2
33
41.8
< 0.001
Constipation
6
5
13
16.5
0.007
Weight loss
81
67.5
49
62
0.427
Anemia
119
99.2
79
100
0.931
Short stature
74
61.7
52
65.8
0.552
Hypocalcemia
85
70.8
52
65.8
0.455
Depression
0
0
2
2.5
0.08
Skin lesion
20
16.7
11
13.9
0.764
Table 2 Type of anemia in typical and atypical celiac disease
Microcytic hypochromic
Normocytic normochromic
Macrocytic hypochromic
P value
n
%
n
%
n
%
0.931
Typical
111
93.3
7
5.9
1
0.8
Atypical
74
93.7
4
5.1
1
1.3
Table 3 Serological finding in both the typical and atypical groups
Typical, n = 120
Atypical, n = 79
P value
n
%
n
%
Total IgA deficient
22
18.3
8
10.1
0.074
Anti-tTG IgA-positive
58
48.3
48
60.8
0.086
Anti-tTG IgA-negative
40
33.3
23
29.1
0.315
Table 4 Histological findings in the typical and atypical celiac disease group
Marsh-Oberhuber classification
Typical, n = 120
Atypical, n = 79
P value
n
%
n
%
0
6
5
2
2.5
0.386
1
8
6.7
10
12.7
0.149
2
0
0
0
0
3a
24
20
29
36.7
0.009
3b
31
25.8
25
31.6
0.372
3c
47
39.2
10
12.7
< 0.001
3b-c
4
3.3
3
3.8
0.862
Table 5 Histological findings in the seropositive (normal IgA level+ positive anti-tTG IgA) and seronegative (normal IgA level + negative anti-tTG IgA) celiac disease
Marsh-Oberhuber grade
CD seronegative, n = 63
CD seropositive, n = 106
P value
n
%
n
%
0.007
0
0
0
7
6.6
1
8
12.7
8
7.5
2
0
0
0
0
3a
21
33.3
20
18.9
3b
23
36.5
29
27.4
3c
10
15.9
36
34
3b-c
1
1.6
6
5.7
Table 6 Histological findings in the seronegative typical and atypical celiac disease group
Marsh-Oberhuber classification
Typical, n = 40
Atypical, n = 23
P value
n
%
N
%
0.315
0
0
0
0
0
1
4
10
4
17.4
2
0
0
0
0
3a
13
32.5
8
34.8
3b
13
32.5
10
43.5
3c
9
22.5
1
4.3
3b-c
1
2.5
0
0
Table 7 Histological findings in the seropositive (106 patients) typical and atypical celiac disease group
Marsh-Oberhuber classification
Typical, n = 58
Atypical, n = 48
P value
n
%
n
%
0.022
0
5
8.6
2
4.2
1
3
5.2
5
10.4
2
0
0
0
0
3a
6
10.3
14
29.2
3b
14
24.1
15
31.3
3c
27
46.6
9
18.8
3b-c
3
5.2
3
6.3
Citation: Mansour HH, Mohsen NA, El-Shabrawi MH, Awad SM, Abd El-Kareem D. Serologic, endoscopic and pathologic findings in pediatric celiac disease: A single center experience in a low/middle income country. World J Clin Pediatr 2022; 11(3): 295-306