Background:Literature information regarding clinical and histological correlates in celiac disease is limited. The present study was designed to assess the value of various clinical parameters in predicting the severity of small bowel histopathology.Methods:Small bowel biopsy specimens of 59 children with established celiac disease (ESPGAN criteria) were evaluated blindly. Morphology was evaluated based on a common histopathology score. The following clinical variables were evaluated: age at diagnosis, duration of symptoms, severity score of clinical symptoms, severity score of physical signs, and growth parameters (height and weightZscores). Multiple regression analysis was performed to evaluate the relative importance of each clinical parameter.Results:Only three clinical variables revealed a significant correlation with the histopathology score. The symptom severity score (t= 3.883,p= 0.0003) demonstrated a positive correlation. The two others, age at diagnosis (t= 3.076,p= 0.0032) and duration of symptoms (t= -2.987,p= 0.0041), revealed a negative correlation.Conclusions:We conclude that more severe clinical symptoms of a shorter duration, presented at a younger age, are better predictors of a more severe form of small bowel histopathology in children with celiac disease.