Vitamin D and K status influences bone mineral density and bone accrual in children and adolescents with celiac disease

Mager, Diana R.; Qiao, Jie; Turner, Justine

doi:10.1038/ejcn.2011.176

Cited by 64 publications

(49 citation statements)

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“…Vitamin and mineral deficiencies may also be seen depending on malabsorption. The limited number of studies performed regarding the frequency of vitamin and mineral deficiencies in adult patients with celiac disease reported the frequency of vitamin and mineral deficiencies in varying rates up until now (11,14,17). A recent study Our particular study has revealed the presence of zinc deficiency in two-thirds of the patients with celiac disease at the time of diagnosis and vitamin D deficiency in more than half.…”

Section: Discussionmentioning

confidence: 99%

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Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Topal¹,

Çatal²,

Acar³

et al. 2015

Turk J Med Sci

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IntroductionCeliac disease is a chronic autoimmune disease that particularly affects the proximal small bowel (1). An autoimmune-mediated mechanism plays a part in the pathophysiology of the disease, and small bowel mucosal injury and malabsorption occur due to the hypersensitivity to gluten in prone individuals. Vitamin and mineral deficiency may also be seen depending upon malabsorption. Consequently, the clinical symptoms of the disease are not limited to the gastrointestinal system and may appear with a heterogeneous clinical spectrum involving the extraintestinal system. The typical symptoms of the disease include chronic diarrhea, abdominal distention, and growth retardation (2,3). However, the disease may also manifest itself with extraintestinal findings related to the hematologic, endocrine, and autoimmune systems. Anemia is the most frequently seen disorder in the hematologic system that often develops due to iron deficiency (4-9). Hypocalcemia and osteopenia may also occur due to vitamin D deficiency (10,11). No extensive study has been conducted regarding the vitamin and mineral deficiencies of pediatric patients diagnosed with celiac disease up to the present. Accordingly, it is the objective of this study to determine the frequency of vitamin A, D, and E deficiency, as well as zinc and mineral deficiencies, in pediatric patients diagnosed with celiac disease at the time of application to our clinic. Materials and methodsThe files of the patients diagnosed with celiac disease and followed in our Pediatric Gastroenterology, Hepatology, and Nutrition Clinic from June 2008 to June 2013 were reviewed retrospectively. Patients with complete file records and vitamin and mineral levels checked at the time of application were enrolled in the study. The demographic characteristics, complaints at the time of application, findings of duodenal biopsy, and serum 25 OH vitamin D, vitamin A, vitamin E, iron, and zinc levels of the patients were taken from the file records. The study was approved by the Ethics Committee of İnönü University (approval number 162/2013).The diagnosis of celiac disease was established in accordance with the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition's guidelines Background/aim: To establish the frequency of vitamin and mineral deficiency in children newly diagnosed with celiac disease. Materials and methods:The files of patients diagnosed with celiac disease in our Pediatric Gastroenterology Clinic from June 2008 to June 2013 were reviewed retrospectively.Results: A total of 52 pediatric patients diagnosed with celiac disease via serology and duodenal biopsy and who fulfilled the study criteria were enrolled in the study. The mean diagnosis age of the patients was 8.5 ± 3.9 years and 33 (63.5%) of the patients were female. Vitamin D, vitamin A, vitamin E, zinc, and iron deficiencies were determined in 27 (51.9%), 4 (7.7%), 7 (13.5%), 35 (67.3%), and 18 (34.6%) patients, respectively, at the time of diagnosis. Vitamin D deficiency was observed more frequent...

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Section: Discussionmentioning

confidence: 99%

“…Patients with celiac disease experience metabolic bone diseases, including osteoporosis, osteopenia, and bone fractures (10,(17)(18)(19)(20)(21). There are several factors that affect the development of metabolic bone disease in patients with celiac disease.…”

Section: Discussionmentioning

confidence: 99%

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Topal¹,

Çatal²,

Acar³

et al. 2015

Turk J Med Sci

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“…The small bowel damage from activated CD 8 + cells is characterized histologically by an invasion of lymphocytes into the epithelium and lamina propria, progression to crypt hyperplasia, and fi nally to blunting of intestinal villi (2) . Resolution of these intestinal lesions can occur after the removal of the inciting proteins from the susceptible individual ' s diet (8,9) . Untreated CD, however, is associated with malnutrition in 67 % of patients (10) .…”

Section: Introductionmentioning

confidence: 99%

Is vitamin D deficiency a feature of pediatric celiac disease?

Villanueva

Maranda

Nwosu

2012

Journal of Pediatric Endocrinology and Metabolism

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Background: Celiac disease (CD) is an autoimmune enteropathy characterized by villus atrophy and malabsorption of essential nutrients. Vitamin D defi ciency has been described in autoimmune diseases, but its status in prepubertal children with CD has not been adequately studied. Objective: To determine the vitamin D status of prepubertal children with CD. Study design: A retrospective study of prepubertal children aged 3 -12 years with CD (n = 24) who were compared to prepubertal, non-CD children of the same age (n = 50). Children were included in the study if they had a diagnosis of CD by intestinal biopsy, and were not on a gluten-free diet (GFD). Patients were excluded if they had diseases of calcium or vitamin D metabolism, or were receiving calcium or vitamin D supplementation or had other autoimmune diseases. All subjects had their serum 25-hydroxyvitamin D [25(OH)D] level measured. Results: There was no difference in 25(OH)D level between the CD and non-CD children (27.58 ± 9.91 vs. 26.20 ± 10.45, p = 0.59). However, when the patients were subdivided into obese and non-obese groups, the non-obese CD patients had a signifi cantly higher 25(OH)D level than the obese normal children (28.39 ± 10.26 vs. 21.58 ± 5.67, p = 0.009). In contrast, there was no difference in 25(OH)D level between non-obese CD patients and non-obese normal children (28.39 ± 10.26 vs. 30.64 ± 12.08, p = 0.52). The season of 25(OH)D measurement was not a signifi cant confounder (p = 0.7). Conclusions: Our data showed no difference in 25(OH) D levels between normal children and those with CD when adjusted for body mass index.

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“…In CD as well, low levels of vitamins A, E [47,49] and K [56] are found due to intestinal absorption impairment. Vitamin K is important for the hepatic synthesis both for coagulation factors (factors II, VII, IX, and X) and for coagulation inhibitors (protein C and protein S).…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

Dima

Jurcuţ²,

Manolache³

et al. 2018

JGLD

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Background & Aims: Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients.Methods: Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms “celiac disease” AND “blood coagulation disorders”, “hemorrhage”, “hematoma”, “hematuria”, “hemoptysis”, “epistaxis”, “hemosiderosis”.Only case reports were identified on the search theme. Information on patients’ characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized.Results: We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review of the literature and summarized the published case reports of 46 CD patients, aged between 19 and 74 years, 64% of male gender. In 25% of cases, the symptomatology was present for more than 5 years prior to CD diagnosis. The clinical hemorrhagic events were as follows: 15 patients had gastrointestinal bleeding, 9 hemoptysis, 4 epistaxis, 6 hematuria, 8 cutaneous hematoma, petechia or ecchymoses, and only in 1 case hemarthrosis, hemorrhagic vesicular dermatitis, subcortical hemorrhage, or adrenal hemorrhage. Sixty percent of the patients had digestive symptoms, while the rest had only extradigestive CD involvement. The Lane Hamilton syndrome was defined in 15 patients. The evolution under a gluten-free diet was favorable in most cases.Conclusion: This review of case reports aims to increase awareness to hemorrhagic events, rare but possible life-threatening conditions, as part of the CD clinical spectrum. To the best of our knowledge, this is the first review of all types of hemorrhagic events in adult CD patients.

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Vitamin D and K status influences bone mineral density and bone accrual in children and adolescents with celiac disease

Cited by 64 publications

References 39 publications

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Is vitamin D deficiency a feature of pediatric celiac disease?

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

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