Current Status Of Celiac Disease Diagnosis In Children And Adolescents In West Algeria

Introduction. The celiac disease is an autoimmune chronic inflammatory enteropathy caused by the gluten gliadin, a food antigen. Objective. To determine whether the epidemiology and the clinical presentation of celiac disease (CD) have changed during the last 30 years in children and adolescents in west Algeria.Subjects and methods. This was a retrospective analysis of all CD subjects listed in the regional reference center, the Department of Pediatrics «C » CHU Oran. Cases were enrolled in the whole west Algeria, from 1978 to December 31 2010. The analyses focused on the study of clinical records. Only subjects who developed CD clinical and histological signs with a positive response to gluten-free diet were considered. Results. CD patients (4476 (2076 male and 2400 female, sex ratio 0.86) were identified. The evolution of CD incidence showed that the number of cases increased gradually since 1980 to 200 cases per year from 1990 to 1997, with peaks around 230 in 1990, 1993 and 1997, then stabilized at around 88 cases per year from 2006 to 2010. Although the mean age at introduction of gluten in the diet and the mean duration of breast feeding have not changed over the past 30 years, an increase in the mean age was noted at first symptoms and at diagnosis. Diarrhea remained the main symptom at diagnosis, its frequency was estimated at 86% until December 31th 2008, but non-diarrheal presentations were increased in recent years. Conclusion. A change in the clinical profile of CD was noted in the last decade, probably related to environmental factors still unidentified in our context.