Abstract
Background: This study was performed to describe the main differences and similarities of celiac disease according to age and highlight the clinical features, diagnosis, associations of the disease, complications, and response to a gluten-free diet in children and adults. Methods: A retrospective study was conducted on a series of patients (n = 223) diagnosed with celiac disease during infancy (< 2 years) and childhood (≥ 2 years) versus a series of adult patients (≥ 17 years). Results: A total of 223 patients were included in this study, 40, 109, and 74 of whom were infants, children, and adults, respectively. The age of diagnosis was delayed in adults, with a mean value of 21.07 ± 12.49 years versus 03.37 ± 3.93 and 6.53 ± 3.77 years in infants and children, respectively (P < 0.001). The clinical manifestations in infants and children were defined as digestive disorders, mainly chronic diarrhea (P = 0.004), similar in adults. Nevertheless, the extra digestive manifestations were predominant in adults, and anemia was the most frequent manifestation (51.4%) versus 30% (n = 12) and 33.9% (n = 37) in infants and children, respectively (P = 0.026), while weight loss in adults affected 52.7% (P for the difference between the three age groups = 0.004). In adults, there was a higher frequency of associated autoimmune diseases, including hypothyroidism (8.1% versus 4.6% in children), Crohn’s disease (5.4% versus 0.0% in children), and lupus (0.9% versus 0.0% in children) (P < 0.001). Serology was strongly positive in all three age groups but with no significant difference between them (P = 0.184). The difference between the three age groups concerning the immunoglobulin G (IgG) anti-transglutaminase (a-tTG) assay positivity was statistically significant (P < 0.001). The partial grade of villous atrophy was dominant in all three groups. Good adherence to the diet was more noticeable in children than adults (P = 0.001). Conclusions: Celiac disease presents differences between adults and children. The atypical clinical presentation is dominant in adults. Children present a positive serology and good adherence to the diet.