Perfil de la enfermedad celíaca en los pacientes con síndrome de Down

Introduction and objective

Individuals with Down syndrome (DS) are a major risk group for coeliac disease (CD). The aim of this study is to find differences in the CD profile in this group in order to take a different medical approach.

Patients and methods

This observational, descriptive and comparative study included 81 patients aged under 15 years monitored between January 1999 and December 2008. Patients were divided into two groups, a first group including 28 children with CD and DS, and a second age- and sex-matched group of 53 children with CD and no DS. Retrospective data from medical records were analyzed.

Results

There were no statistically significant differences in age at diagnosis, clinical presentation, symptoms at diagnosis, body measurements, serological markers and histological data. Members of the DS group were significantly likelier to have no family history of CD or an association with autoimmune thyroiditis. Breastfeeding was initiated less frequently in the DS group, and the introduction of gluten was significantly delayed. The genetic study showed a significantly high frequency of the DQ8 heterodimer in patients with SD.

Conclusions

The clinical profile of CD in children with DS appears to be similar to that for children without this condition. The risk heterodimer distribution in DS individuals in this series differs from published data. Some nutritional features in this population could entail new risk factors that might trigger the onset of CD.