Coeliac disease in children in Christchurch, New Zealand: Presentation and patterns from 2000-2010

Table 1 Presenting symptoms or signs in 263 children diagnosed with coeliac disease in Christchurch, New Zealand n (%)

	Presenting sign or symptom	Children
Gastrointestinal	Abdominal pain	115 (43.6)
	Diarrhoea	101 (38.3)
	Bloating (± increased flatus)	60 (22.7)
	Nausea and vomiting	42 (15.9)
	Constipation	17 (6.4)
Nutritional	Iron deficiency (± anaemia)	84 (31.8)
	Poor weight gains/wasting	65 (24.6)
	Weight loss	27 (10.2)
	Micronutrient deficiency	25 (9.5)
	Short stature	10 (3.8)
Extra-gastrointestinal	Lethargy	36 (13.6)
	Poor health/recurrent infections	12 (4.6)
	Irritability/low mood	11 (4.2)
	Headaches	6 (2.3)
	Pubertal delay	3 (1.1)
	Poor sleep	2 (0.8)
	Neuropsychiatric symptoms	1 (0.4)
Asymptomatic	Identified following screening	38 (14.4)

The presenting features prior to diagnosis were noted. Some children had more than one presenting feature.

Table 2 Nutritional parameters in children diagnosed with coeliac disease, stratified by age

Age group(yr)	WeightZ score (± SD)	HeightZ score (± SD)	Iron deficiency (n)	Other deficiency (n)
0-5	-0.4096 ± 1.24	-0.4210 ± 1.102	41	9
6-12	0.1196 ± 0.966	-0.914 ± 1.125	25	8
> 12	0.0901 ± 1.14	-0.229 ± 1.347	21	7

Children aged less than five years of age had lower weight Z scores than the other groups (P = 0.0033), but there were no differences in height Z scores between the groups. Other deficiencies included those with low levels of folate, vitamin B12, vitamin A, vitamin D, vitamin E or vitamin K.

Table 3 Oesophageal and gastric findings in 263 children diagnosed with coeliac disease

	Histological diagnosis	Number of patients	Percentage of patients (%)
Oesophageal findings	Reflux oesophagitis	21	7.9
	Eosinophilic oesophagitis	4	1.5
	Candida oesophagitis	1	0.4
	Non-specific oesophagitis	21	7.9
Gastric findings	Lymphocytic gastritis	16	6.1
	Non-specific gastritis	30	11.4
	Reactive gastritis (bile reflux)	11	4.2
	Active chronic gastritis (H. pylori)	1	0.4
	Gastric metaplasia	1	0.4

Eighty-six of the 263 children diagnosed with coeliac disease were found to have one or more oesophageal or gastric findings on review of endoscopic biopsies. H. pylori: Helicobacter pylori.