Which of the following is NOT a common clinical symptom of celiac disease in childhood?

• A. Precocious Puberty
• B. Failure to Thrive
• C. Constipation
• D. Anemia

Answer: (A)

In children with celiac disease, the typical issues come from malabsorption in the small intestine, which leads to growth problems and nutritional deficiencies. That malnutrition often shows up as failure to thrive or poor weight gain, and iron-deficiency anemia is a common consequence of reduced absorption. Constipation can also be a presenting feature in some kids with celiac, reflecting the variable ways gut function can be affected. Precocious puberty, however, is not a usual consequence of gluten-induced intestinal damage. Malnutrition from celiac more commonly delays or disrupts normal pubertal development rather than triggering early puberty. So, while the other symptoms fit the expected pattern of pediatric celiac disease, precocious puberty does not, making it the not-common presentation.