Celiac disease in children and adolescents with Down syndrome

Nisihara, Renato; Kotze, Lorete Maria da Silva; Utiyama, Shirley Ramos da Rosa; Oliveira, Nanci P.; Fiedler, Patrícia T.; Messias-Reason, Iara

doi:10.2223/jped.1381

Cited by 47 publications

(30 citation statements)

References 18 publications

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“…This increase is comparable with increases found by studies in other countries. 1 The 5.6% prevalence observed by the study is within the range of the many different prevalence rates cited in the world literature. The number of patients who the study discovered suffer concomitantly from CD becomes even more significant if we consider that the fifth patient who had a positive antiendomysium antibody (EMAIgA) test almost certainly had celiac disease too.…”

supporting

confidence: 79%

Doença celíaca: a afecção com múltiplas faces

Pratesi¹,

Gandolfi²

2005

J. Pediatr. (Rio J.)

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supporting

confidence: 79%

Doença celíaca: a afecção com múltiplas faces

Pratesi¹,

Gandolfi²

2005

J. Pediatr. (Rio J.)

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“…When Sattar and cols., excluded patients with type-1 diabetes and Down syndrome, there was no higher prevalence of CD compared with the general population. Nisihara and cols., investigated children with Down syndrome from the same area of Brazil and showed a high prevalence of confirmed CD (5.6%) (18). Our sample with ATD patients had a higher prevalence of IgA-EmA than the control group and a higher prevalence of CD than the general population, and there were no cases of type-1 diabetes and Turner or Down syndrome among the evaluated individuals.…”

Section: Discussionmentioning

confidence: 56%

“…However, this study included patients with Down syndrome and type-1 diabetes. CD is associated with Down and Turner syndromes and other conditions that have autoimmune features, such as type-1 diabetes mellitus (17,18). When Sattar and cols., excluded patients with type-1 diabetes and Down syndrome, there was no higher prevalence of CD compared with the general population.…”

Section: Discussionmentioning

confidence: 99%

Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil

Teixeira

Nisihara

Utiyama

et al. 2014

Arq Bras Endocrinol Metab

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Objective: The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern Brazil. Subjects and methods: From the years 2007 to 2011, 254 patients with ATD were enrolled consecutively, Grave's disease was diagnosed in 143 (56.3%) and Hashimoto's thyroiditis in 111 (43.7%) of them. All patients answered a questionnaire related to symptoms that could be associated with CD and serum samples to screen for IgA anti-endomysial (EmA-IgA) were collected. EmA-IgA-positive patients were offered upper gastrointestinal endoscopy and biopsy of duodenum. Results: A total of 254 patients were included; 222 (87.4%) female, mean age 45.4 ± 13.43 years (18 to 79 years). EmA-IgA was positive in seven patients (2.7%) and five done endoscopy with biopsy. Of these, three diagnosis of CD was confirmed (1.2%). All the three patients with CD had higher EmA-IgA titration, were female and had Hashimoto's thyroiditis. Like other patients with ATD, CD patients had nonspecific gastrointestinal symptoms, such as heartburn and gastric distention. In our study, one in each 85 patients confirmed the diagnosis of CD. Conclusion: We found a prevalence of 1.2% (1:85) of confirmed CD among Brazilian patients with ATD. Although some IgA-EmA positive patients had Graves' disease and one was male, all three patients with confirmed CD were female and had Hashimoto's thyroiditis.

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“…Considering the total universe of patients with DS, the frequency of autoimmune thyroid disease is described to be between 20% and 66%, depending on the type of study, sample size, region, age group and the inclusion of hypo-or hyperthyroidism cases (13)(14). It is possible that previous studies also included DS patients with TSH-nd, without TH and without hypothyroidism, producing a large number of false positive results.…”

Section: Discussionmentioning

confidence: 99%

TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis

Faria

Ribeiro

Kochi

et al. 2011

Arq Bras Endocrinol Metab

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INTRODUCTION: Patients with Down syndrome (DS) often have elevated TSH (hypothalamic origin), which is called TSH neurosecretory dysfunction (TSH-nd). In these cases, there is slight elevation in TSH (5-15 µUI/mL), with normal free T4 and negative thyroid antibodies (AB). OBJECTIVE: To recognize the risk of progression to Hashimoto's thyroiditis (HT). SUBJECTS AND METHODS: We retrospectively analyzed 40 DS patients (mean age = 4.5 years), followed up for 6.8 years. RESULTS: HT was diagnosed in 9/40 patients, three early in monitoring, and six during evolution. In 31/40 patients, TSH-nd diagnosis remained unchanged over the years, with maximum TSH values ranging from 5 to 15 µUI/mL. In this group, free T4 also remained normal and AB were negative. There was a significant TSH reduction (p = 0.017), and normal TSH concentrations (< 5.0 µUI/mL) were observed in 29/31 patients, in at least one moment. No patient had TSH > 15 µUI/mL. CONCLUSION: DS patients with TSH-nd present low risk of progression to HT (10% for females and 6% for males).

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Celiac disease in children and adolescents with Down syndrome

Abstract: These data indicates a high prevalence (5.6%) of confirmed celiac disease in Down syndrome patients from southern Brazil.

Cited by 47 publications

References 18 publications

Doença celíaca: a afecção com múltiplas faces

Doença celíaca: a afecção com múltiplas faces

Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil

TSH neurosecretory dysfunction (TSH-nd) in Down syndrome (DS): low risk of progression to Hashimoto's thyroiditis

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