Bones loss in children with celiac disease does not depend on the presence of symptoms

Given (intentional or non-intentional) dietary gluten exposure, growing children with celiac disease may experience poor absorption of nutrients, negatively affecting bone health. Now a new study published in the Journal of Pediatric Gastroenterology and Nutrition by Canadian researchers from University of Alberta and the Alberta Health Services shows that loss of bone density in celiac children does not depend on the presence of symptoms at diagnosis. Moreover, the research revealed that the older the age at which the child was diagnosed, the higher the likelihood of bone loss.

The researchers studied 74 children aged between 3 and 16 years, and analyzed bone mineral density of the spine to determine the presence and degree of bone loss. An equivalent reduction in spine bone mass was observed in children with celiac disease at diagnosis regardless of the presence of symptoms. However, bone density was inversely correlated with age at diagnosis.

The researchers conclude their study by suggesting that delayed diagnosis of children with celiac disease may increase the risk of adult osteoporosis and that, even in the absence of symptoms, appropriate screening of children at risk of celiac disease for the purpose of early diagnosis, as well as routine evaluation of bone mineral density in such children, are important to prevent long-term complications associated with poor bone health.

Source: Prevalence of Metabolic Bone Disease in Children With Celiac Disease Is Independent of Symptoms at Diagnosis. Journal of Pediatric Gastroenterology and Nutrition. Turner, Justine; Pellerin, Genevieve; Mager, Diana. 2009 Jul 28. [Epub ahead of print]

Celiac disease may strike the elderly too

Celiac disease doesn’t only affect the young, new research from Finland confirms, but can strike a person for the first time in later life.

Source: Reuters Health, July 24,2009

In people with celiac disease, eating gluten-a protein found in many types of grain-causes the immune system to launch an attack on the small intestine.  While people may think of the condition as a problem for children and young adults, they add, Vilppula and her team recently identified cases of celiac disease in elderly people. In some individuals, the condition had not been detected.

In the current study, the researchers investigated whether some older people had actually developed celiac disease later in their lives, or the disease had simply gone undetected. They looked at 2,815 people over 55 who had undergone blood tests for celiac disease in 2002, 2,216 of whom were screened again in 2005. The researchers also did biopsies of patients’ small intestines to confirm the blood test findings.

In 2002, 2.13% of the study participants had biopsy-confirmed celiac disease, while 2.34% did in 2005. There were five new cases among people whose blood tests had initially been negative for the disease, and only two of these individuals had symptoms. That led the researchers to conclude that the elderly could develop the disease late in life.

Past research has shown that undetected celiac disease can lead to significant health problems in older people, the researchers note; in one study including 35 people 60 and older, 15 had been seeing their doctor for 28 years, on average, with symptoms without being diagnosed.

Doctors should be aware of the possibility that their older patients may have or develop celiac disease, Vilppula and colleagues say, and they should use blood tests to confirm the diagnosis-even though a negative test doesn’t mean a person won’t develop the condition later on.

SOURCES:
Reuters Health, July 24,2009
BMC Gastroenterology, online June 29, 2009.

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