277 Assessment of nutritional status of children with a newly diagnosed coeliac disease – a 10-year tertiary centre experience

Introduction and Aims Coeliac disease is an immune-mediated systemic disease caused by gluten consumption that occurs in children and adults with a hereditary predisposition. The clinical features of the disease are diverse, and the most common symptoms in children are chronic diarrhoea, failure to thrive, vomiting, abdominal pain and chronic constipation. In some children, if cases when there is increased risk for coeliac disease despite the absence of symptoms and signs of the disease, targeted serological screening can be undertaken. The aim of the study was to assess and compare the nutritional status in symptomatic patients and children in whom the diagnosis of coeliac disease was made based on screening. Methods This was a single-centre, retrospective, observational study involving all children diagnosed with coeliac disease at the Referral Centre for Paediatric Gastroenterology and Nutrition, at Children’s Hospital Zagreb, in the period from 1 January 2010 to 1 January 2020. Nutritional status data were obtained from a systematic review of patients’ electronic data. Results During the study period, coeliac disease was diagnosed in 166 children (70 boys, mean age 7.47 years, age range 6 months to 17.5 years). In 28 children (16.37%) the disease was detected by screening. Data on body weight (BW), body height (BH) and body mass index (BMI) were recorded at the time of diagnosis in 137 children (82.5%) and based on the available data, Z-scores corrected for age and sex were determined for BW, BH and BMI for age and sex. The mean BW Z-score was -0.40 (-0.47 in symptomatic children vs -0.05 in children identified by screening, p 0.05), a delay in linear growth (Z-score Conclusion At the time of diagnosis, BW and BMI of symptomatic children were significantly lower than in children with coeliac disease identified through screening, a total of 16.05% of children were malnourished. Normal linear growth was recorded in both groups. Most of the symptomatic children had normal nutritional status at the time of diagnosis, and the nutritional status in almost all children detected by screening was normal. In conclusion, normal nutritional status does not rule out the disease and should not deter a physician from conducting a targeted screening for coeliac disease.