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Canadian Journal of Gastroenterology and Hepatology
Volume 28, Issue 7, Pages 351-354
Pediatric Gastroenterology & Hepatology

Exploring Anthropometric and Laboratory Differences in Children of Varying Ethnicities with Celiac Disease

Seema Rajani,1 Abeer Alzaben,2 Leanne Shirton,3 Rabindranath Persad,4 Hien Q Huynh,4 Diana R Mager,2,5 and Justine M Turner4,6

1Department of Pediatrics, Food & Nutritional Science, University of Alberta, Canada
2Department of Agricultural, Food & Nutritional Science, University of Alberta, Canada
3Pediatric Gastroenterology and Nutrition, Multidisciplinary Pediatric Celiac Clinic, Stollery Children’s Hospital, Canada
4Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, University of Alberta, Canada
5Alberta Diabetes Institute, Stollery Children’s Hospital, Edmonton, Alberta, Canada
6Multidisciplinary Pediatric Celiac Clinic, Stollery Children’s Hospital, Edmonton, Alberta, Canada

Received 12 May 2014; Accepted 9 June 2014

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Celiac disease (CD) is a common autoimmune disorder with an increasing prevalence, including in ethnic minorities.

OBJECTIVE: To report the frequency of CD diagnosis in ethnic minorities presenting to a Canadian pediatric celiac clinic and to determine whether ethnic differences exist at diagnosis or follow-up.

METHODS: Patients with biopsy-proven CD diagnosed at a multidisciplinary celiac clinic between 2008 and 2011 were identified through the clinic database. Data at referral, and six-month and 12-month follow-ups were collected. These included demographics, self-reported ethnicity, symptoms, anthropometrics and laboratory investigations, including serum immunoglobulin antitissue transglutaminase (aTTG).

RESULTS: A total of 272 patients were identified; 80% (n=218) were Caucasian (group 1) and 20% (n=54) were other ethnicities. South Asians (group 2) comprised 81% (n=44) of the minority population. No differences in age or sex were found between the two groups. Group 1 patients presented more often with gastrointestinal symptoms (71% versus 43%; P<0.001), while patients in group 2 presented more often with growth concerns (21% versus 68%; P<0.001). At diagnosis, serum aTTG level was consistently lower in group 1 compared with group 2 (367 IU/mL versus 834 IU/mL; P=0.030). Both groups reported symptom improvement at six months and one year. At the end of one year, aTTG level was more likely to be normal in group 1 compared with group 2 (64% versus 29%; P<0.001).

CONCLUSION: Although they represent a minority group, South Asian children comprised a significant proportion of CD patients presenting to a Canadian celiac clinic. South Asian children were more likely to present with growth concerns, which has important implications for timely diagnosis in this population. In addition, the apparent delay in normalization of aTTG levels suggests that careful follow-up and culturally focused education supports should be developed for South Asian children with CD.