Celiac disease more frequent on people with Down syndrome

Celiac disease is an autoimmune condition caused by gluten, a protein present in wheat, barley, and rye, and other related prolamins. People with this condition cannot consume it because it damages the small intestine. This condition affects genetically disposed to it and can manifest in different ways depending on the individual. Symptoms can manifest on the digestive system or other body parts. Irritability is one of the common symptoms on kids, and can also be manifested with diarrhea, abdominal pain, and even depression; nonetheless, other individuals may not manifest any symptoms whatsoever.

There is evidence that celiac disease is more frequent in people that suffer from different genetic and autoimmune diseases, like diabetes type I, thyroid disease, autoimmune hepatitis, and Down syndrome. Down syndrome is an anomaly where a remnant of genetic material causes a delay on how a kid develops, physically and mentally. Kids with Down syndrome tend to share certain physical features like small ears, and tongue thrust.

Symptoms and traits manifested in children with Down syndrome can delay the identification of celiac disease and can result in confusion. In some cases there is stunt growth, anemia, and constipation; common conditions on kids with Downs syndrome. Major complications can arise without a timely detection.

An association between Down syndrome and celiac disease has been an important subject and has been recently studied. A meta-analysis performed in 2017 by the College of Life and Environmental Sciences of Beijing researchers determined that the prevalence of celiac disease with Down syndrome varies from 0% to 19%. Recommendations for screening of Down syndrome and celiac disease are still topic of conversation and there is still a lack of guidelines based on evidence. Reviews based on existing reports indicate that there is a need to establish standardized diagnose criteria that is immediately applicable.

Celiac disease is present on babies and children, from 9 to 36 months old, and it is characterized by a gradual manifestation and rarely on an abrupt way. Patients with Down syndrome have a higher disposition to show birth defects, leading to higher celiac disease incidences. Actual evidence have important implications to support a mandatory detection of celiac disease on patients with Down syndrome.

World Down Syndrome Day is commemorated on March 21. The UN aims to raise public awareness on this syndrome and remember the substantial contributions made by all the people with an intellectual disability.

Reviewers: Brenda Giselle Álvarez Rodríguez (Public Health Research), and Cassandra Saldaña Pineda (Knowledge Management Unit).

Sources:

• Article: “Prevalence of celiac disease in patients with Down syndrome: a meta-analysis”. 2018 Jan 12; 9(4): 5387–5396.
• Article: “Screening of celiac disease in Down syndrome – Old and new dilemmas”. World J Clin Cases. 2017 Jul 16; 5(7): 264–269.
• Article: “Detecting celiac disease in patients with Down syndrome”. American Journal of Medical Genetics Part A. Volume 170, Issue 12. Dec 16; 3098–3105
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