J Pediatr Gastroenterol Nutr. 2023 Aug 1;77(2):240-243. doi: 10.1097/MPG.0000000000003819.Epub 2023 Apr 28.

Amrita Bhattacharjee ¹, Kieryn Houlder ², Daniela Migliarese Isaac ¹, Atilano Lacson ³, Justine Turner ¹

Author information

¹From the Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.

²the Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.

³the Department of Laboratory Medicine and Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.

Abstract

The prevalence of pediatric serological negative celiac disease (SNCD) is poorly described, with few recognized clinical predictors beyond immunoglobulin A (IgA) deficiency or reduced gluten intake. The purpose of this retrospective review was to describe the prevalence of SNCD at the Stollery Children's Hospital and identify clinical features to help in recognition of these cases. Patients with a positive biopsy and negative serology (SNCD) were compared to those with positive biopsy and serology. SNCD diagnosis required clinical correlation and either confirmatory genetics or follow up endoscopy on a gluten-free diet. Of the 424 patients who met celiac disease (CD) criteria, 4.7% (n = 20) fulfilled our criteria for SNCD. There was a significant difference in the rates of IgA deficiency between the 2 groups, but no other clinical features were found that allowed for ready identification of SNCD patients.