Epidemiological, Clinical, Histological, Serological and Therapeutic Study of Children Celiac Disease in Western Algeria Region

Abstract

Objectives: To determine the epidemiological, clinical, histological, serological and therapeutic profile of celiac disease in children in Western Algeria region.Methods: 250 patients over a period of three years (2016 - 2019) from the pediatric department of the University Hospital of Oran (West Algeria) were included in our retrospective study.Results: We noticed a female predominance with a sex ratio F/M = 1.57. Symptoms were defined by typical (73.2%) and atypical (26.8%) forms, digestive disorders (47.2%), extra digestive disorders (14.4%). Anemia was noted at 73.6%, and the association with autoimmune diseases at 14.8%. Seropositivity was present in 77.6% of cases and histology revealed partial grade villous atrophy at 54%. We noticed a significant link between the histological grade and the serology (p = 0.001), between age and histological grade (p<10-3), between bone age and body mass index (p = 0.017), between the age of onset of the disease and the age of food diversification (p = 0.030), and with the age of breastfeeding (p = 0.026). In addition, we found an excellent correlation between anti-transglutaminase and anti-endomysium autoantibodies during diagnosis and under diet (p<10-3), and between serology during diagnosis and serology under diet (p = 0.002)Conclusion: Celiac disease (CD) of children in western Algeria is characterized by a variety of clinical symptoms. The gluten-free diet remains the only therapy for these affected children.
 Keywords: celiac disease, children, epidemiology, serology, histology, associated diseases, treatment.

Comparative Profile of Celiac Disease Between Children and Adults in Western Algeria Region

“…The serological tests were necessary for the diagnosis of the disease, although the current study's results showed that serology was positive in 85.2% of celiac patients. The present study's results are similar to the results of other studies (21,24), recalling that even in infants (90.0%), children (80.7%), and (89.2%) adults, the tests mainly (IgA and IgG a-tTG, IgA endomysial antibodies, and IgA antigliadin antibodies) were significantly higher for children than adults, which underlines an excellent predictive value to confirm the diagnosis (25,26). A The histological test defined by a duodenal biopsy remains an examination of reference to confirm the diagnosis of celiac disease.…”

“…Moreover, the total grade (Marsh ≥ 3) was present in adults more frequently than in children. The aforementioned results were also reported by other studies (21,27).…”

“…Unlike in the infant group, where allergy was followed by anemia as the main associated disease, Vivas et al (18) suggest that anemia is one of the associated diseases in infants and children. Anemia, hypothyroidism, and type 1 diabetes were the main associated comorbidities confirmed by the results of El Mehadji et al's study (21). In addition, the literature has shown that celiac disease is associated with autoimmune diseases, mainly type 1 diabetes and hypothyroidism (22,23).…”