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World J Clin Cases. Jul 16, 2017; 5(7): 264-269
Published online Jul 16, 2017. doi: 10.12998/wjcc.v5.i7.264
Screening of celiac disease in Down syndrome - Old and new dilemmas
Momcilo Pavlovic, Karolina Berenji, Marko Bukurov
Momcilo Pavlovic, Karolina Berenji, Marko Bukurov, College of Vocational Studies in Subotica, 24000 Subotica, Serbia
Author contributions: Pavlovic M wrote the first draft; Berenji K and Bukurov M reviewed, provided critical input and comments.
Conflict-of-interest statement: The authors declare that there is no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Momcilo Pavlovic, MD, PhD, Professor, College of Vocational Studies in Subotica, Solohova 3/18, Banijska 67, 24000 Subotica, Serbia. momodec@tippnet.rs
Telephone: +381-63-8233331
Received: March 6, 2017
Peer-review started: March 10, 2017
First decision: March 27, 2017
Revised: April 28, 2017
Accepted: May 3, 2017
Article in press: May 5, 2017
Published online: July 16, 2017
Processing time: 129 Days and 7.2 Hours
Abstract

Celiac disease (CD) is a common and well defined autoimmune disorder caused by gliadin and related proteins of wheat, rye, and barley. Epidemiologic studies confirmed that CD is highly associated with other autoimmune diseases and with Down syndrome (DS). The symptomatic form of CD in patients with DS is more frequent than asymptomatic forms. However, growth impairment, anemia, intermittent diarrhea, and constipation are symptoms and signs typically of children with DS without CD. Late identification of the disease can lead to various complications, sometimes even very severe. Therefore, systematic screening for CD is essential in the management of children and adolescents with DS. Many medical organizations recommend screening in this group of patients. However, current policy statements vary in their recommendations for screening and there is still a need for establishing uniform diagnostic criteria.

Keywords: Down syndrome; Celiac disease; Children; Screening; Practice guideline

Core tip: Celiac disease (CD) is more common in children with Down syndrome (DS) than in general population. Recommendations for screening for DS and CD remain controversial and we still lack standard evidence-based guidelines. This review, based on existing reports, indicates the need for establishing uniform and immediately applicable diagnostic criteria.