Prevalence of celiac disease among children with Down syndrome attending the genetics clinic at Alexandria University Children Hospital

Background Celiac disease (CD) is an immune-mediated disease affecting the small intestine secondary to gluten exposure. The currently available treatment is lifelong adherence to a gluten-free diet. Several disorders have a higher risk to develop CD, including Down syndrome (DS). In several studies, the prevalence of CD in DS ranged between 4 and 17%. CD is prevalent in Arabs; however, few studies have been performed to determine the prevalence of CD in DS patients. Aim This study aimed to estimate the prevalence of CD in Egyptian children with DS. Patients and methods This study was performed as a cross-sectional study. The patients were recruited from the Genetics Outpatient Clinic at Alexandria University Children Hospital. Screening for CD was done by using only serological markers: anti-tissue transglutaminase-immunoglobulin A (IgA) and total IgA followed by anti-endomysial antibody and small bowel biopsy for positive cases. HLA typing was not performed before serology. Results The total number of the study sample was 54. The mean age was 4.26±1. 94 years ranging from 2 to 12 years; 61.1% of cases were men. All studied children had normal serum total IgA. Serum transglutaminase-IgA was elevated in three (5.6%) cases. Endomysial antibody was positive in two of them. Histopathological analysis confirmed the diagnosis of CD in two (3.8%) patients; one of them was completely asymptomatic. Conclusion Our study showed a confirmed prevalence of 3.8% for CD in the studied Egyptian patients with DS based on serology and biopsy. This result indicates the need for regular screening of these patients for CD.