Clinical evaluation of children with celiac disease: A single-center experience

Abstract

Background and objectives:The clinical fi ndings of Celiac Disease (CD) change over time. Instead of classical symptoms such as diarrhea, growth retardation, abdominal bloating, atypical symptoms such as chronic constipation and abdominal pain may be the only sign of CD. In this study, we aimed to evaluate the clinical features of our patients with CD. Material and methods: This retrospective study was conducted between March 2017 and January 2019. 61 children with CD were included in the study. Local Ethics Committee approval was received. As an initial diagnostic test, tissue transglutaminase antibody (tTG) IgA test and total IgA test were analysed in all patients. Endomysial antibody (EMA) IgA test was analysed in patients with positive tTG IgA. If both celiac tests are detected as positive, gastroduodenoscopy was performed for defi nitive diagnosis of CD.Results: Of the 61 patients, 37 (60.6%) was female. The mean age of patients was 8.28±4.28 years. Tissue transglutaminase antibody (tTG) IgA test was positive in all patients, then endomysial antibody (EMA) IgA test was analysed in those patients. Endomysial antibody IgA test was also positive in all patients except three. The pathological results of our patients were Marsh 3a in 30 patients, Marsh 3b in 19 patients, and Marsh 3c in 12 patients. The positive family history of CD was found in the fi rst degree relatives of 6 asymptomatic patients. Those patients were diagnosed with CD after celiac screening tests and endoscopic biopsy. Most of our patients had more than one symptom; 33 patients (54.1%) had classical symptoms such as failure to thrive and diarrhea, and 25 patients (40.9%) had non-classical symptoms. Conclusion:The fi rst degree relatives of celiac patients even if asymptomatic, and all patients with uncertain complaints and abnormal laboratory fi ndings associated with CD should be evaluated for CD.

Short Stature as a Major Manifestation of Celiac Disease in Children 1-14 years of age at Shaikh Zayed Hospital Lahore

“…The mean age of the children is 7.7±3.3 years in our study which is comparable with other local and regional studies 9,14,15 . Data stratification according to gender has shown female preponderance in our study: there was significant relationship between asymptomatic CD and female gender (P value= 0.08).…”

Association of HLA‐DQ4/5 genotype polymorphisms with celiac disease in a group of children in Southwest Iran: A case‐control study

“… 7 , 8 An analysis of children with CD found that the presence of Hashimoto thyroiditis, Turner syndrome, Down syndrome, diabetes mellitus, and hypothyroidism all contributed to the possibility of CD in these children. 9 To mitigate the risk of enduring complications, such as malignancy, stunted growth, infertility, and reduced bone density, it is imperative to diagnose CD as early as possible and initiate treatment. 10 , 11 Single‐nucleotide polymorphism (SNP)‐based assays are economical and effective at detecting common variants associated with CD, such as HLA‐DQ7.5, DQ2.2, DQ8, and DQ2.5.…”

“… 19 The ratio of affected females to males in CD varies from 1:3 to 1.5:1; this disease is known to affect individuals of all ages, with more than 70% of new diagnoses occurring in individuals over 20 years old. 9 , 20 European nations (such as Finland and Sweden) and people of European ancestry demonstrate an increased susceptibility to developing CD in contrast to other geographic areas. 21 Additionally, The prevalence of CD is different among countries, and it is believed to affect approximately 1% of the overall population in Iran.…”

“…On the other hand, if the TGA‐IgA level is less than 10 times the upper limit of normal (<10 × ULN), a biopsy is necessary to minimize the risk of a false‐positive diagnosis 7,8 . An analysis of children with CD found that the presence of Hashimoto thyroiditis, Turner syndrome, Down syndrome, diabetes mellitus, and hypothyroidism all contributed to the possibility of CD in these children 9 . To mitigate the risk of enduring complications, such as malignancy, stunted growth, infertility, and reduced bone density, it is imperative to diagnose CD as early as possible and initiate treatment 10,11 .…”

“…The prevalence of CD among the general population varies from 0.5% to 2%, averaging around 1%, 18 yet this 1% rate nearly doubles when screening projects are carried out among school‐aged children 19 . The ratio of affected females to males in CD varies from 1:3 to 1.5:1; this disease is known to affect individuals of all ages, with more than 70% of new diagnoses occurring in individuals over 20 years old 9,20 . European nations (such as Finland and Sweden) and people of European ancestry demonstrate an increased susceptibility to developing CD in contrast to other geographic areas 21 .…”