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Pediatric Gastroenterology Practice Attuned to Celiac Disease<6>
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Stuart H. Berezin, MD
summarized by Sue Goldstein
Stuart H. Berezin, M.D., is a Pediatric Gastroenterologist at
Westchester County Medical Center, Valhalla, NY, and an Associate
Professor at New York Medical College. On April 16th, Dr. Berezin
spoke about the Reemergence of Celiac Sprue in the Hudson Valley, at a
roundtable discussion held during the first annual Hudson Valley
Childrens Hospital Conference at West Point, NY, sponsored by the
Office of Continuing Medical Education of New York Medical College.
Dr. Berezin stated that there had been typically one or two children
diagnosed with Celiac Disease in his group pediatric gastroenterology
practice in past years, but in the last year, nine children were
diagnosed, ranging in age from one year to 20 years old. Its
incredible because there has been such a marked increase in the number
of patients weve been diagnosing with Celiac Disease. We had seen
some articles that indicated that Celiac Disease in children is
decreasing in frequency, but this hasnt been our experience at all.
One of the things that has been so fascinating to Dr. Berezin, and
one of the reasons the groups physicians wanted to do the roundtable
discussion is that there has been such a diverse presentation of
symptoms. Weve had a few children who presented with just abdominal
distention -- no weight loss and no diarrhea -- basically healthy
appearing children who proved to have Celiac Disease. We've had
children in the hospital who were admitted for neurological problems,
such as loss of developmental landmarks. One of these children
additionally had microcephaly (abnormal smallness of the head). After
an extensive neurological evaluation, we were subsequently asked to
see the child only because the child was having some mild problems
with diarrhea and vomiting. It was not felt that these were the
childs primary problems, but it turned out the child had Celiac
Disease. All the problems reversed on the gluten-free diet, including
the microcephaly and the gastrointestinal problems, and the child
started developing normally neurologically.
Dr. Berezin stated that the groups pediatric gastroenterologists have
become much more attuned to Celiac Disease. Weve all been so amazed
this past year, and its been an education for us. We now do the
screening antibodies testing on any child that comes in with any
symptom that in any way could be attributed to Celiac Disease.
Actually, weve been surprised ourselves with the diagnosis of Celiac
Disease in a lot of patients. This has also had a positive effect in
increasing awareness of Celiac Disease among pediatricians. A lot of
the pediatric groups are becoming attuned to Celiac Disease after weve
diagnosed their patients--we try to keep in contact with the
pediatricians so now they become more aware of the diverse
presentations.
Celiac Disease is a very gratifying disease to diagnose because you
can see a patient who is extraordinarily ill, and two weeks later
theyre healthy. So many other diseases that we see have no quick
cure. Dr. Berezin recently saw an eight-year-old girl who had been
diagnosed with Celiac Disease when she was about two. We hadnt seen
her in several years, and she was in just for a check-up. This kid is
amazing...shes a great athlete...a gymnast, a swimmer, and she has
straight A's. I asked her, "How is it dealing with this diet?" and
she said, "It's really not a problem." It was a pleasure to see
someone who is so well adjusted and is doing so spectacularly.
The Pediatric Gastroenterology group practice at Westchester County
Medical Center [in New York] includes Leonard J. Newman, M.D.;
Michael Halata, M.D.; Howard E. Bostwick, M.D.; Christian Rosioru,
M.D.; and Stuart H. Berezin, M.D.
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