Evaluation of Demographic and Clinical Characteristics of Celiac Patients: A Single Center Experience Characteristics of Pediatric Celiac Patients
Article Sidebar
Main Article Content
Abstract
Objective: Celiac disease (CD) is an autoimmune disorder among genetically predisposed subjects exposed to gluten-containing foods. It is now appreciated that CD is now recognized as a common condition among persons of various ethnic groups and both adults and children, and that affects many organ systems. This study was conducted to evaluate the demographic and clinical characteristics of pediatric celiac patients.
Patients and Methods: A total of 122 individuals diagnosed with CD by serologic and histologic assessments between January 2010 and December 2016 were enrolled in the study.
Results: : Forty-three patients were boys (35.2%), and seventy-nine were girls (64.8%). The mean age was 12.6±5.7 years, and the mean age at diagnosis was 8.8±5.1 years. The most frequent presenting symptoms were abdominal pain (41%), failure to thrive (36.1%), and diarrhea (34.4%). Adherence to a gluten-free diet was 67.2%. Family history of CD was positive in 2.5% of patients. The most frequent comorbidities were iron deficiency anemia (36.1%), vitamin D deficiency (12.3%), and type-1 diabetes mellitus (7.4%). Endoscopic assessments revealed dentations in 61.5% of cases, and histologic evaluations told that Marsh 3b was the most frequent histologic grade (27.9%). IgA and IgG transglutaminase antibody levels were decreased significantly following the initiation of the gluten-free diet.
Conclusion: Celiac disease faces a very varied picture in terms of clinic and laboratory at the time of diagnosis and in the follow-up. Early diagnosis of CD is critical to prevent long-term complications; currently, the only effective treatment is a lifelong gluten-free diet.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2023-03-07
Published 2023-03-12
References
Decker E, Hornef M, Stockinger S. Cesarean delivery is associated with celiac disease but not inflammatory bowel disease in children. Gut microbes. 2011;2(2):91-8.
Onur T, Karaca Ü, Çelik MG. Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. Medical Bulletin of Haseki/Haseki Tip Bulteni. 2021;59(1).
Fasano A, Catassi C. Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum. Gastroenterology. 2001;120(3):636-51.
Caio G, Volta U, Sapone A, Leffler DA, De Giorgio R, Catassi C, et al. Celiac disease: a comprehensive current review. BMC medicine. 2019;17(1):1-20.
Cichewicz AB, Mearns ES, Taylor A, Boulanger T, Gerber M, Leffler DA, et al. Diagnosis and treatment patterns in celiac disease. Digestive diseases and sciences. 2019;64(8):2095-106.
Oxentenko AS, Rubio-Tapia A, editors. Celiac disease. Mayo Clinic Proceedings; 2019: Elsevier.
Karasu D, Karaca U, Ozgunay SE, Yilmaz C, Yetik F, Ozkaya G. The frequency of emergence delirium in children undergoing outpatient anaesthesia for magnetic resonance imaging. International Journal of Clinical Practice. 2021;75(11):e14763.
Kuloğlu Z. Çölyak hastalığı. Türkiye Çocuk Hastalıkları Dergisi. 2014;8(2):105-11.
Tanner JM, Whitehouse RH. Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Archives of disease in childhood. 1976;51(3):170-9.
Soylu Ö, Ecevit ÖÇ. Clinical evaluation of cases followed-up for celiac disease. Journal of Dr Behcet Uz Children's Hospital. 2013;3(1):38-43.
Dinler G, Atalay E, Kalaycı AG. Celiac disease in 87 children with typical and atypical symptoms in Black Sea region of Turkey. World Journal of Pediatrics. 2009;5(4):282-6.
Megiorni F, Mora B, Bonamico M, Barbato M, Montuori M, Viola F, et al. HLA-DQ and susceptibility to celiac disease: evidence for gender differences and parent-of-origin effects. Official journal of the American College of Gastroenterology| ACG. 2008;103(4):997-1003.
Tokgöz Y, Terlemez S, Karul A. Fat soluble vitamin levels in children with newly diagnosed celiac disease, a case control study. BMC pediatrics. 2018;18(1):1-5.
Telega G, Bennet TR, Werlin S. Emerging new clinical patterns in the presentation of celiac disease. Archives of pediatrics & adolescent medicine. 2008;162(2):164-8.
Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Journal of pediatric gastroenterology and nutrition. 2005;40(1):1-19.
Karaca Ü, Karasu D, Eminoğlu Ş, Özgünay ŞE, Onur T, Kılıçarslan N. Evaluation of state and trait anxiety levels in adolescents undergoing endoscopy under anesthesia: A prospective study. 2022.
Ramírez-Cervantes KL, Romero-López AV, Núñez-Álvarez CA, Uscanga-Domínguez LF. Adherence to a gluten-free diet in Mexican subjects with gluten-related disorders: a high prevalence of inadvertent gluten intake. Revista de Investigación Clínica. 2017;68(5):229-34.
Taghdir M, Honar N, Mazloomi SM, Sepandi M, Ashourpour M, Salehi M. Dietary compliance in Iranian children and adolescents with celiac disease. Journal of Multidisciplinary Healthcare. 2016;9:365.
Esenyel S, Ünal F. Depression and anxiety in child and adolescents with follow-up celiac disease and in their families. 2014.
Dalgic B, Sari S, Basturk B, Ensari A, Egritas O, Bukulmez A, et al. Prevalence of celiac disease in healthy Turkish school children. Official journal of the American College of Gastroenterology| ACG. 2011;106(8):1512-7.
Rahmati A, Shakeri R, Sohrabi M, Alipour A, Boghratian A, Setareh M, et al. Correlation of tissue transglutaminase antibody with duodenal histologic marsh grading. Middle East journal of digestive diseases. 2014;6(3):131.
Ganji A, Esmaeilzadeh A, Bahari A, Ghafarzadegan K, Aghayee MA, Mozafari HM, et al. Correlation between cut-off level of tissue transglutaminase antibody and marsh classification. Middle East Journal of Digestive Diseases. 2016;8(4):318.
Emami MH, Karimi S, Kouhestani S, Hashemi M, Taheri H. Diagnostic accuracy of IgA anti-tissue transglutaminase in patients suspected of having coeliac disease in Iran. J Gastrointestin Liver Dis. 2008;17(2):141-6.
Bibbò S, Pes GM, Usai-Satta P, Salis R, Soro S, Colosso BMQ, et al. Chronic autoimmune disorders are increased in coeliac disease: a case–control study. Medicine. 2017;96(47).
Cosnes J, Cellier C, Viola S, Colombel JF, Michaud L, Sarles J, et al. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clinical Gastroenterology and Hepatology. 2008;6(7):753-8.
Viljamaa M, Kaukinen K, Huhtala H, Kyrönpalo S, Rasmussen M, Collin P. Coeliac disease, autoimmune diseases and gluten exposure. Scandinavian journal of gastroenterology. 2005;40(4):437-43.