CELIAC DISEASE - AN ENTITY, SEVERAL PRESENTATION MODES.

Background. Celiac disease (gluten-sensitive enteropathy) is one of the major diagnostic entities related to malabsorption syndrome; it has a multifactorial etiology. There are different clinical forms: classic form, latent form, silent form, potential form. Aim. The paper aimed to present some examples of celiac patients with differences in symptoms, clinical signs and diagnostic steps. Material and methods. We present, from personal casuistry, the evolution - to the diagnosis and under diet therapy - of some pediatric patients with celiac disease. Results: MB was addressed for diarrheal stools with onset in infancy, having heredo-collateral history of celiac disease (his father); he had a mild weight deficiency, anemic syndrome, and rapid test (detection of IgA antibodies in blood) was positive; his parents refused digestive endoscopy and initiated gluten-free diet without diagnosis confirmation; at one year's check, the nutritional state was normal, without anemia, the mother reporting the appearance of modified stools if the child consumed small amounts of gluten food. AB presented for irritability, the impossibility of walking, sleepiness; her physical development was normal, with a slightly neuro-motor retardation (walking at 1.2 years); she had a recent episode of respiratory infection followed by greenish diarrhea, abdominal pain and meteorism (labeled as post-antibiotic disbiosis); encephalitis and enteroinfection were ruled-out; laboratory test reveal huge values of the anti-transglutaminase antibodies and deamidated gliantin peptide antibodies; the diagnosis was celiac crisis, with favorable evolution under treatment. Conclusions. The cases we have described reflect the clinical variability of this condition. Having several clinical presentation forms, celiac disease should be suspected and the patient should be carefully investigated irrespective of the type of manifestations (gastrointestinal or extradigesthetic); diagnosis involves symptoms, serological dosing, HLA testing and duodenal biopsy (mandatory). [ABSTRACT FROM AUTHOR]