Celiac disease in children with Down syndrome

Abstract

Celiac disease (CD) in children with Down syndrome (DS) has been published by several countries, without available data for Colombia.

Objective: To determine the frequency and related factors of CD in children with DS, compared with a group of children without DS, analyzing the clinical, immunological, and genetic manifestations.

Patients and Method: A total of 209 children between 1-18 years of age (8.4 ± 4.1 years, 55.5% female) were studied, 97 with DS and 112 without DS, using anti-transglutaminase antibodies as serological marker (tTG2). Variables of age, gender, race, origin, weight, height, and digestive symptoms were studied. Children with positive tTG2 underwent duodenal biopsy and genotype. The proportion of children with DS, without DS, and CD was estimated and their 95% CI; measures of central tendency, univariate and bivariate analysis, considering a p < 0.05 significant.

Results: Eight children with DS (8.2%) and five children without DS (4.5%) were tTG2 positive (p = 0.200). None presented serum IgA deficiency. One child with DS presented CD with Marsh II (1.0%), and two children with DS (2.1%) and two without DS (1.8%), presented potential CD (p = 0.432). Three children were HLA-DQ2. CD was more likely in the preschool group (OR = 6.14 95%CI = 0.41-87.35 p = 0.0462).

Conclusions: The CD frequency due to intestinal biopsy in children with DS is much lower than that reported in the literature, being associated with preschool, and having DQ2 as its main allele. These findings are similar to those described worldwide.