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DOWN'S SYNDROME: COELIAC DISEASE/GLUTEN SENSITIVITY. Key Points.
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(based on DSMIG Clinical Awareness Notes. J Dennis, C.Charlton. G Holmes)
- Prevalence 4 - 17% depending on age of sample and country of origin
- May be associated with type 1 diabetes and/or thyroid disease
- Clinical diagnosis difficult because of overlap with normal features
of the syndrome therefore need to have low threshold of clinical suspicion
- Whole population screening not currently recommended.
- AGA screen not useful in DS population. AEA effective
- AEA screen for all with major or minor symptoms as follows:
- Disordered bowel function tending to diarrhoea or to new onset
constipation
- Failure to thrive as indicated using Down's syndrome specific
reference charts (Harlow Printing 2000);
- Abdominal distension
- General unhappiness and misery
- Arthritis
- Rash suggesting dermatitis herpetiformis
- Existing type 1 diabetes, thyroid disease or anaemia
- If AEA positive, or if negative but with significant symptoms, proceed
to small intestinal biopsy as in general population.
- Treat with gluten free diet as for general population
- Dietary compliance seems no more problematic than in general population
© DSMIG 8.11.01
This page is also available as a PDF.
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