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Serum tTGA levels can be used to predict villous atrophy and biopsy may be avoided in strongly suspected cases with more than 9 times of cut-offs.

Background: Vitamin B12 deficiency is common in children but under diagnosed disorder. Helicobacter pylori infection plays an important role in the development of atrophic gastritis and related malabsorption. There may be a relationship between H.Pylori infection and vitamin B12 deficiency. Aims and Objective: To find out prevalence of Helicobacter pylori infection by endoscopic and histopathological findings, in children aged 2-18 years, with vitamin B12 deficiency. Materials and Methods: Seventy-eight patients with deficient serum vitamin B12 levels were evaluated. Upper GI Endoscopy was performed in all cases and gastric biopsies were obtained for histopathological examination and evidence of H. pylori infection. Results: Tissue biopsy revealed chronic atrophic gastritis in 09 patients and chronic antral gastritis in 52 patients. H. pylori infection by histology was positive in 45(57.70%) patients. We found significant correlation between atrophic gastritis and H. pylori infection, as well as between H. pylori infection and B12 deficiency. Conclusion: H.pylori has an effect on gastric mucosa, which affects the absorption of vitamin B12. Thus individuals with B12 deficiency should be subjected for diagnostic evaluation of H.pylori infection so that appropriate therapy can be initiated.

Objectives: To assess the occurrence of serum vitamin D, zinc, iron and copper deficiency in children with newly diagnosed coeliac disease (CD) as compared to healthy controls at a tertiary care centre in Western Rajasthan, India Method: A case control study was conducted in the Gastroenterology Clinic, Department of Paediatrics, Dr S. N. Medical College, Jodhpur, India for a period of one year. Sixty consecutive newly diagnosed CD patients between 2-18 years of age, confirmed via serology and duodenal biopsy, who fulfilled the study criteria, were enrolled as cases in the study. Representative samples of 30 age-and-sex matched healthy subjects were taken as controls. Serum levels of vitamin D, zinc, iron and copper were assessed at diagnosis in cases and controls.Results: Mean age of the cases in the study was 6.19 ± 3.42 years. Serum vitamin D, zinc, iron and copper deficiency were seen in 55%, 40%, 58.3% and 11.7% cases respectively. The median (IQR) of serum vitamin D (p=0.002), zinc (p<0.001) and iron (p=0.003) were significantly lower in cases as compared to controls. A statistically significant correlation was seen between serum tissue transglutaminase (TTG) and mean serum vitamin D levels of cases in the study group (p<0.05) and between vitamin D levels and short stature (p <0.001).Conclusions: Vitamin D, zinc and iron deficiencies were more frequently observed in children with newly diagnosed CD as compared to healthy controls.