Lacrimal Hyposecretion in Children With Celiac Disease

Abstract

Purpose: : To assess the prevalence of lacrimal hyposecretion in children with celiac disease as compared to control group and the impact of a gluten free-diet.

Methods: : A test group of 65 children with celiac disease (38 males, median age 9.4 ± 2.3 years) was compared with a control group of 65 healthy children matched for gender and age. The diagnosis of celiac disease was performed according to the modified criteria of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. All children answered the validated McCarty symptom questionnaire to investigate the presence and the score of ocular discomfort symptoms and underwent to the Schirmer test with topical anesthesia. The Schirmer test was considered abnormal in presence of values ≤ 5mm/5minutes. The Schirmer test was repeated after 12 months of a gluten free-diet in all children with celiac disease.

Results: : Eight celiac children complained of dry eye symptoms versus one of control group (12.3% vs 1.5%; p=0.037, chi-square test). The median score of Schirmer test was significantly lower in celiac children as compared to controls (9.4 ± 3.4 mm vs 12.9 ± 4.2 mm; p=0.000, t-test). The Schirmer test was abnormal in five children and in one control (7.7% vs 1.5%; ns, chi-square test). After 12 months of a gluten-free diet the Schirmer test significantly improved in children with celiac disease (11.5 ± 3.7 mm; p=0.000, paired t-test).

Conclusions: : Lacrimal secretion is reduced in children with celiac disease and a gluten free-diet have a beneficial effect. Screening for celiac disease may be indicated in children with lacrimal hyposecretion.

Keywords: cornea: tears/tear film/dry eye • lacrimal gland