الفهرس 
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Abstract
Celiac disease (CD), gluten sensitive enteropathy, is a chronic immune-mediated systemic disorder triggered by the ingestion of gluten-containing cereals (wheat, barley and rye) in genetically susceptible individuals. It may affect as much as 1-2% of the general population.
The clinical presentation of CD varies greatly between the completely asymptomatic form to the full blown picture with malabsorption which represent the tip of the celiac iceberg. The ”non-classical” or ”atypical” presentations of CD are being increasingly recognized.
Certain medical conditions have been recognized to possess a higher risk for CD compared to general population as type 1 DM, autoimmune thyroid disease, first degree relatives of CD, Turner syndrome and Down syndrome.
Down syndrome is a chromosomal disorder characterized by presence of three copies of chromosome 21. Such cases as mentioned before are described to be one of the high risk groups that can develop CD more than the general population.
In the present study our aim is to detect the prevalence of CD in children with DS who present to the genetics outpatient clinic in Alexandria University Children´s Hospital.
To achieve this goal, 54 children with DS were included in this study. All children were evaluated clinically. CBC, serum albumin, and IgA tissue transglutaminase(ttg) were done for all children and IgA EMA only for those with positive anti ttg. Upper gastrointestinal endoscopy and intestinal biopsy were performed only for serologically positive children.