IgA and IgG Antitransglutaminase 2 Antibodies in the Diagnosis of Celiac Disease

Villanueva, Mónica; Rojas, Marianela; Araya, Magdalena

doi:10.12691/ijcd-5-2-7

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“…Due to the increase in the diagnosis frequency, in several countries, national programs have been incorporated in order to improve their management, for which national information is essential. In our country, the evaluations currently available show that the existing data are scarce and almost entirely obtained in the Metropolitan Region 8,11 . The Concepción District belongs to the Biobío Region and is made up of 12 communes (Concepción, Coronel, Chiguayante, Florida, Hualqui, Lota, Penco, San Pedro de la Paz, Santa Juana, Talcahuano, Tomé).…”

Section: Introductionmentioning

confidence: 94%

Caracterización de la enfermedad celiaca en niños atendidos en hospitales públicos chilenos

Méndez

Carrasco

Mora

et al. 2018

Rev. chil. pediatr.

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Caracterización de la enfermedad celiaca en niños atendidos en hospitales públicos chilenosAbstract Introduction: The worldwide prevalence of celiac disease (CD) is ~1% of the population. In Chile, the National Health Survey 2009-2010 showed a serological prevalence in individuals older than 15 years of 0.76% (IgA-tTG2), which corresponded in Concepción to 0.6%. Objective: Determine clinical characteristics, search, diagnosis, treatment and follow-up of CD in the two public hospitals in Concepción that have a Gastroenterology Department. Patients and Method: Descriptive study. Data were collected from electronic medical records (CIE10 code) and medical records of patients younger than 18 years of age, assessed for CD during 2010 -2016 from two public hospitals in the city of Concepción, Chile. Cases whose diagnostic protocol met the ESPGHAN 2012 criteria (confirmation with intestinal biopsy), 207 out of 216 identified patients met the inclusion criteria. The nutritional status was classified according to age group (in children under five years old by WHO 2006 and in children between five and 18 years old by WHO 2007). The Z-score (Z) was calculated using the WHO Anthro software (in children under five years old) and WHO Anthro Plus software (in those between five and 18 years old). Antiendomysial antibodies were assessed by immunofluorescence test in cuts of the esophagus of mono, IgA and IgG anti-transglutaminase antibodies via ELISA, as well as serum IgA. Results: CD was confirmed by duodenal biopsies in 33.8% of the patients. IgA-tTG was identified in 70% and IgG-tTG in 52.9%, although only two patients had IgA deficiency. The main reasons for consultation were gastrointestinal (80%) and/or referral by an endocrinologist (45.7%). The main clinical presentation was gastrointestinal, with diarrhea (71.4%). 17.1% of the patients had Down syndrome (DS), 11.4% short stature, and 5.7% had type 1 diabetes mellitus. At diagnosis, the obesity:malnutrition ratio (Z-score BMI) was 2:1 and 6.8% of the patients were obese. One year after diagnosis, in 26 patients without DS, the frequency of eutrophic patients decreased from 65.4% to 42.3%, increasing overweight from 23.1% to 34.6% and obesity from 0 to 7.7%. Conclusions: In Concepción, endocrinologists conduct a significant and successful active search of CD, being responsible for 47.3% of the diagnoses. The high proportion of overweight/obese patients is consistent with the phenomenon currently described in Chile and other countries.

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Section: Introductionmentioning

confidence: 94%