Clinical studies on celiac disease (2014-2019): systematic review about the age ranged prevalence of clinical presentation and associated diseases

Introduction: Celiac disease (CD) is characterized by a wide variety of signs, symptoms and associated diseases in its presentation, it can even be asymptomatic. Recent studies show the variation of the clinical spectrum according to age. In young children, classic celiac disease predominates with symptoms such as abdominal distension, decreased appetite, diarrhea and weight loss. Frequent atypical manifestations in older children are abdominal pain, constipation, reflux, vomiting, fatigue and short stature. In adults there is a reduction in the classical presentation and an increase in the non-classical. Material and Methods: A systematic review was conducted in which articles on signs and symptoms of classical and atypical CD in children and adults have been included, in addition to the diseases that are frequently associated with this pathology. The databases used to search the articles were PubMed, Web of Science and Scopus, from the last six years (2014-2019). A total of 164 articles have been evaluated following the selection criteria, of which the 20 most relevant articles have been included in the study. Results: CD is diagnosed more frequently in women and at earlier ages than men. In children under two years old, classical CD predominates although more intensely than in young children. In older children, teenagers and adults, the form of presentation changes towards atypical or non-classical and asymptomatic. Conclusions: The increased prevalence in the last years, great heterogeneity of symptoms, associated diseases and the variation of the clinical spectrum towards an atypical form with extraintestinal symptoms causes delay in its diagnosis so they must be recognized to be detected earlier.