IDIOPATHIC CELIAC DISEASE

Abstract

The acute phase of idiopathic celiac disease was studied in 58 patients. The criteria for selection of these cases are stated. The frequency and severity of gastrointestinal symptoms in siblings and other relatives appeared to exceed expectation unless the disease is familial. In the majority of patients studied, symptoms began before the age of 6 months, in 14 at birth. Vomiting was a frequent prodromal symptom. Breast feeding for more than two months was shown to delay the onset of diarrhea. The early onset of symptoms in the present series is believed to be related to the prevalence of formula feeding from early infancy in New York City at present. Severe retardation in growth of the skull was common and occurred at an earlier age than retardation in height. This, at times, led to disproportion between measurements for total body length and head circumference. Ultimate head measurements were normal. The following laboratory procedures were performed in the patients under consideration and their results recorded: pancreatic trypsin and amylase estimation on duodenal drainage, glucose tolerance tests, fecal fat determination, total serum protein, serum carotene and vitamin A levels and vitamin A absorption test. The diagnostic usefulness of these procedures is discussed. Various diseases of infancy which may lead to an erroneous diagnosis of idiopathic celiac disease are discussed.