Prevalence and clinical profile of celiac disease among malnourished children in South Rajasthan, India


  • Mukesh Sharma Department of Paediatrics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
  • Sanjay Mandot Department of Paediatrics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India



Celiac disease, IgA-anti tissue transglutaminase antibodies, Screening


Background: Celiac disease (CD) is the most common genetically related food intolerance, worldwide. The objective of this study was to study the prevalence and clinical profile of malnourished children.

Methods: It was a prospective and observational study. The present study was conducted in the Department of Paediatrics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan. Two hundred and one children were studied. All malnourished children were initially selected and those fulfilling inclusion criteria were included in the study. A detailed interview of all the children/parents was conducted regarding symptoms commonly associated with celiac disease. All cases found positive for t-TGA (>10au/ml) were subjected to upper GI Endoscopy.  Subjects were labelled as celiac disease if tissue trans-glutaminase IgA antibodies were >10 au/ml and histopathology was suggestive. Statistical analysis was done by one way ANOVA test and Chi-square as per requirements also Fisher exact and Man Whitney were applied.

Results: Celiac disease was present in 23.9% of malnourished patients. Most common presenting symptoms were diarrhoea (40.2%), abdominal distension (39.9%) and abdominal pain (36.8%) and most common clinical sign was pallor, which was present in more than three-fourth of the patients (85.9%) followed by multivitamin deficiency (25.4%).

Conclusions: There is a high prevalence of Celiac disease in malnourished children. Screening for Celiac disease (especially in presence of diarrhoea and abdominal distension, pain abdomen) should be an essential part of work-up in all malnourished children.


Gautam A, Jain BK, Midha V, Sood A, Sood N. Prevalence of celiac disease among siblings of celiac disease patients. Indian J Gastroenterol. 2006;25(5):233-5.

Gluten Sensitive Enteropathy. In: Nelson W, Behrman RE, Kliegman RM, Arvin AM, eds. Nelson Textbook of Pediatrics. 15th edition. WB Saunders, Philadelphia; 1996;1095-6.

Green PH, Cellier C. Celiac disease. N Engl J Med. 2007;357:1731-43.

Baker SS. Rethinking strategies to screen for celiac disease. Pediatr. 2014;133:331-2.

Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002;346:180-8.

Al Hatlani MM. Prevalence of celiac disease among symptom-free children from the eastern province of Saudi Arabia. Saudi J Gastroenterol. 2015;21(6):367-71.

Al-Tawaty AI, Elbargathy SM. Celiac disease in north-eastern Libya. Ann Trop Pediatric. 1998;18:27-30.

Sherwani RK, Alam S, Akhtar K, Abid B, Rahman K, Mehdi R. Prevalence of iron deficiency anemia in chronic diarrhoea and celiac disease: a western UP experience. Indian J Hematol Blood Transfusion. 2008;24(1):12-5.

Ludvigsson JF, Bai JC, Biagi F, Card TR, Ciacci C, Ciclitira PJ, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63:1210-28.

Thapa. Celiac disease in chidren: Recent Concepts. JK Sci. 2010;3:3-12.

Beniwal N, Ameta G, Chahar CK. Celiac disease in children with severe acute malnutrition (SAM) a hospital-based study. Indian J Pediatr. 2017;84(5):339-43.

Jora R, Raghuvanshi V, Payal V, Sharma P, Vishnoi SK. Correlation of tissue transglutaminase with modified marsh grading in celiac disease: a prospective cohort study. Indian J Pediatr. 2017;84(7):515-20.

Waheed N, Cheema AH, Suleman H, Fayyaz Z, Mushtaq I, Muhammad, et al. Celiac crisis; electrolyte abnormality; neuromuscular weakness. J Ayub Med Coll Abbottabad. 2016;28(4):672-5.






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