Presentation of Pediatric Celiac Disease in the United States: Prominent Effect of Breastfeeding

• Published in: Clinical pediatrics Vol. 44; no. 3; pp. 249 - 258
• Main Authors: D’Amico, Michael A., Holmes, Jessica, Stavropoulos, Stavros N., Frederick, Marisa, Levy, Joseph, DeFelice, Amy R., Kazlow, Philip G., Green, Peter H. R.
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA SAGE Publications 01.04.2005; Westminster Publications, Inc
• Subjects: Age Distribution; Biopsy; Breast Feeding; Breastfeeding & lactation; Celiac disease; Celiac Disease - diagnosis; Celiac Disease - etiology; Celiac Disease - physiopathology; Child; Child, Preschool; Female; Humans; Infant; Infant Food; Male; Medical diagnosis; Medical disorders; Pediatrics; Prevalence; Surveys and Questionnaires; United States - epidemiology; United States; United States > US
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/000992280504400309

Childhood celiac disease (CD) is considered rare in the United States. Consequently there are few data concerning its clinical presentation. A validated questionnaire was distributed to families of children with CD. One hundred forty-one children with biopsy-proven CD were included in the study. We found significant differences in the clinical spectrum of children based on their infant feeding history. Exclusively breastfed children were significantly less likely to report failure to thrive (69% vs 88%, p<0.05) and short stature (37% vs 62%, p<0.05), and had a higher rate of “atypical” symptoms (p<0.01). Breastfeeding alters the presentation and contributes to atypical presentations of CD and diagnostic delay. Pediatricians need to be aware of the diverse manifestations of celiac disease to reduce diagnostic delay.