Most screen-detected CD cases had no CD-associated symptoms. The most common presenting complain in children ultimately diagnosed with CD were musculoskeletal in nature, rather than gastrointestinal. “Although this finding is not surprising given that the cohort is from a pediatric rheumatology practice, where patients would be expected to present with musculoskeletal rather than GI symptoms, we discovered a surprising number of ‘silent’ cases of CD that presented with no GI complaints at all,” the researchers say.
Gluten restriction relieved some of the musculoskeletal complaints in the children with CD. Given the potential benefits of starting a gluten-free diet early in patients with CD and the dangers of unnecessary immunosuppressive therapies in unidentified celiac cases, “we believe that children presenting for rheumatologic evaluation should be considered a high-risk population and screened for CD as part of the standard initial laboratory evaluation,” they conclude.
The studies had no external funding and the authors have no disclosures. They did not respond to request for comment by press time.