Background: Celiac disease is an immune-mediated disorder characterized by variable
clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy.
Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease
in Kosovar Albanian children.
Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18
years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from
2005 to 2016.
Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis
was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02),
while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2
years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly
presented with gastrointestinal symptoms, while primary school children and adolescents mostly
showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the
cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only
three of them tested negative.
Conclusion: Kosovo, as the majority of developing countries, is still facing the classical form of
celiac disease as the dominant mode of presentation; as a result, most children with other forms of
the celiac disease remain undiagnosed.
Physicians should be aware of the wide range of clinical presentations and utilize low testing
thresholds in order to prevent potential long-term problems associated with untreated celiac disease.