Coeliac disease in Primary Care. A diagnosis to take into account

Celiac disease is defined as a condition of the proximal small bowel that is associated with a permanent intolerance to gluten, a protein contained in some cereals. The pathogenesis of the disease probably relies on the interaction of genetic and immunologial factors celiac disease relies on the interaction of genetic and immunological factors. The prevalence of celiac disease is not well-kwon. Clinical features may be very variable and the classic mode of presentation (related to malabsorption) coexists with other monosymptomatic or even asymptomatic forms of the disease. New diagnostic tools (antigliadin, antiendomysium and antireticulin antibodies) are used for screening celiac disease. The diagnosis is based on histological findings (jejunal biopsy). Removal of gluten from the diet is obligatory because celiac disease may be associated with long-term complications, especially with intestinal lymphoproliferative malignancies. Objetives: To evaluate the prevalence and the clinical features of the coeliac disease at a Primary Healthcare level. Methods: Retrospective study of the pediatric population attended in five health centres. Results: Twenty-two of 6.578 children had celiac disease (prevalence:1/295). The most frequent clinical presentation of the disease was the malabsortive form. Celiac disease was associated with other immunological processes (dematitis herpetiformis, type 1 diabetes mellitus, IgA deficiency) in some patients. Antigliadin and antiendomysium antibodies were sensitive tests in screening for celiac disease.