Ammara Farooq, Taimur Khalil Sheikh, Huma Bashir, Sadaf Haroon.
Celiac disease in children and the impact of late diagnosis.
Isra Med J Jan ;12(3):136-40.

Objective: To compare the typical and atypical celiac patients in terms of different clinical parameters and the impact of late diagnosis. Study Design: A retrospective descriptive comparative study. Place and Duration: Pediatric Outpatient of Federal General Hospital (FGH), Chak Shahzad, Islamabad from 1st January 2018 to 31st December 2019. Methodology: Diagnosed patients with celiac disease were divided into two groups according to typical or atypical symptoms and evaluated for the clinical and biochemical markers and the long term effects of late diagnosis were determined, especially in atypical celiac disease. Results: A total of 50 patients were studied. Mean age at diagnosis was 7.1 years. The younger age was associated with typical symptoms. Most common extra-intestinal manifestations were anemia and short stature, combined or alone. The mean length of late diagnosis was 3.8 years. Urban areas had a high rate of late diagnosis despite having more facilities. The study shows unnecessary investigations and treatment interventions were done especially in atypical celiac disease patients` further delaying diagnosis. Conclusion: Atypical celiac disease is quite common in children and they showed more different aspects of late diagnosis negatively affecting them than the typical ones especially in terms of anemia and short stature.

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