Abstract

Introduction: Celiac Disease (CD) is an immune-mediated disease which is seen in genetically susceptible individuals with CD typical and atypical findings in a wide age range from early childhood to adulthood results from an abnormal inflammatory response to gluten, particularly in the small intestine.

Materials and Methods: In this study 52 patients,( 30 female, 22male), (mean age 6.4 ± 4 years) who were diagnosed as CD in the Department of Pediatric Gastroenterology at Dr. Sami Ulus Children’s Hospital in Ankara between 2004-2005 were evaluated retrospectively in terms of age distribution, presenting symptoms, clinical findings, laboratory data and associated conditions. Results And

Discussion: 38.5% of all cases were in the 6-11 age group. The most common presenting symptom was diarrhea (69.2%) which was decreased with increasing age, and the most common presenting symptoms were failure to thrive (87.5%) (p=0.021) and short height (50%) in the age group of 12 and above. The prevalence of abdominal distension (88.9%) was significant ly higer in children under 2 year of age (p=0.001). The most common finding was short height (75%) in the age group of 12 and above (p=0.17). The most common laboratory finding was anemia (69.2%) and 72% of the anemic patients had iron deficiency anemia. While endomysium antibody (EMA) IgA or tissue transglutaminase (tTG) IgA positivity in the 0-2 age group was 66.7%, it was 83% in the age group of 2 and above (p=0.23). The most common clinical form (78.8%) was typical CD and the most common histopathological type was destructive-type (Marsh Type 3) CD (82.7%). While atypical and asymptomatic/silent CD were observed in older patients, the prevalence of typical CD under 5 years was significant ly more common(p=0.003). In our study, associated conditions with CD were IgA deficiency, type 1 diabetes, autoimmune thyroiditis, Down syndrome, Evans syndrome, and giardiasis

Keywords: Celiac disease, childhood, gluten sensitivity

References

  1. Selimoğlu MA. Çölyak Hastalığı. 1. Baskı. İstanbul: Logos yayıncılık,2008:6.
  2. Mehta G, Taslaq S, Littreford S, Bansi DS, Thillainayagam A. The changing face of the coeliac disease. Br J Hosp Med (Lond) ;69:84-87. Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG, North American Society for Pediatric Gastroenterology, Hepa- tology and Nutrition.Guideline for the Diagnosis and Treatment of Celiac Disease in Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005;40:1-19.
  3. Maki M, Lohi O. Celiac Disease. In: Walker WA, Goulet O, Klein- man RE, Sherman PM, Shneider BL, Sanderson IR(eds). Pediatric Gastrointestinal Disease. 4th ed. Ontario:B.C.Decker,2004:932
  4. Ertekin V, Selimoğlu MA, Kardaş F, and Aktaş E. Prevalen- ce of celiac disease in Turkish children. J Clin Gastroenterol ;39:689-691. Demirçeken FG, Kansu A, Kuloğlu Z, Girgin N, Güriz H, Ensari A. Human tissue transglutaminase antibody screening by immu- nochromatographic line immunoassay for early diagnosis of celiac disease in Turkish children. Turk J Gastroenterol 2008;19:14-21.
  5. Doğancı T. Çocuklarda çölyak hastalığının klinik bulguları. Seli- moğlu MA. (Ed). Çölyak Hastalığı. 1. Baskı. İstanbul:Logos ya- yıncılık, 2008:43-48.
  6. Farrell RJ, Kelly CP. Celiac Sprue. N Engl J Med 2002; 346: 180
  7. Ivarsson A, Persson LA, Nyström L, and Hernell O. The Swedish coeliac disease epidemic with a prevailing twofold higher risk in girls compared to boys may reflect gender specific risk factors. Eur J Epidemiol 2003;18:677-684.
  8. Kotze LM, Utiyama SR, Nisihara RM, de Camargo VF, Ioshii SO. IgA class anti-endomysial and anti-tissue transglutaminase anti- bodies in relation to duodenal mucosa changes in coeliac disease. Pathology 2003;35:56-60.
  9. Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fomaroli F, Wasserman SS, Murray JA, Horvath K. Prevalence of celiac disease in at risk and not at risk groups in the United States: a large multicenter study. Arch Intern Med 2003;163:286-292.
  10. Hoffenberg EJ, MacKenzie T, Barriga KJ, Eisenbarth GS, Bao F, Haas JE, Erlich H, Bugawan TIT, Sokol RJ, Taki I, Norris JM, Re- wers M. A prospective study of the incidence of childhood celiac disease. J Pediatr 2003;143:308-314.
  11. Hill I, Fasano A, Schwartz R, Counts D, Glock M, Horvath K. The prevalence of celiac disease in at risk groups of children in the United States. J Pediatr 2000;136:86-90.
  12. Carlsson A, Axelsson I, Borulf S, Bredberg A, Ivarsson S-A. Sero- logical screening for celiac disease in healthy 2,5 year old children in Sweden. Pediatrics 2001;107:42-45.
  13. Ertekin V. Dünyada ve Türkiye’de çölyak hastalığı prevalansı. Selimoğlu MA. (Ed). Çölyak Hastalığı. 1. Baskı. İstanbul:Logos yayıncılık,2008:11-17.
  14. Lebenthal E, Branski D. Celiac disease: An emerging global prob- lem. J Pediatr Gastroenterol Nutr 2002;35:472-474.
  15. Catassi C, Fasano A. New Developments in Childhood Celiac Di- sease. Cur Gastroenterol Rep 2002;4:238-243.
  16. Maki M, Kakkonen K, Lahdeaho ML, Visakorpi JK. Changing pattern of childhood celiac disease in Finland. Acta Paediatr Scand 1988;77:408-412.
  17. Hill ID, Bhatnagar S, Cameron DJ, De Rosa S, Maki M, Russell GJ, Troncone R. Celiac disease: Working group report of the first world congress of pediatric gastroenterology, hepatology and nut- rition. J Pediatr Gastroenterol Nutr 2002;35:S78-S88.
  18. Bonamico M, Scire G, Mariani P, Pasquino AM, Triglione P, Scac- cia S, Ballati G, Boscherini B. Short stature as the primary mani- festation of monosymptomatic celiac disease. J Pediatr Gastroen- terol Nutr 1992;14:12-16.
  19. Demir H, Yüce A, Kocak N, Ozen H, Gürakan F. Celiac dise ase in Turkish children: presentation of 104 cases. Pediatr Int ;42:483-487. Mora S, Barera G, Ricotti A, Weber G, Bianchi C, Chiumello G. Reversal of low bone density with a gluten-free diet in children and adolescents with celiac disease. Am J Clin Nutr 1998;67:477
  20. Abaci A, Esen I, Ünüvar T, Arslan N, Bober E. Two cases pre- senting with pubertal delay and diagnosed as Celiac disease. Clin Pediatr (Phila) 2008;47:607-609.
  21. Altuntaş B, Kansu A, Ensari A, Girgin N. Celiac disease in Turkish short statured children and the value of antigliadin antibody in diagnosis. Acta Paediatr Jpn 1998;40:457-460.
  22. Vanderschueren-Lodeweyckx M, Wolter R, Molla A, Engermont E, Eeckels R. Plasma growth hormone in coeliac disease. Helv Pediatr Acta 1973;28:349-357.
  23. Lecornu M, David L, Francois R. Low serum somatomedin acti- vity in celiac disease. Helv Pediatr Acta 1978;33:509-516.
  24. Kalayci A, Kansu A, Girgin N, Küçük O, Aras G. Bone mineral density and importance of a gluten-free diet in patients with celiac disease in childhood. Pediatrics 2001;108: e89.
  25. Kavak US, Yüce A, Koçak N, Demir H, Saltik IN, Gürakan F, Ozen H. Bone mineral density in children with untreated and tre- ated celiac disease. J Pediatr Gastroenterol Nutr 2003;37:434-436.
  26. Kalaycı AG. Kemik sağlığı ve çölyak hastalığı. Selimoğlu MA. (Ed). Çölyak Hastalığı. 1. Baskı. İstanbul:Logos yayıncılık,2008:93-99.
  27. Abrams JA, Diamond B, Rotterdam H, Green PH. Seronegative celiac disease: Increased prevalence with lesser degrees of villous atrophy. Dig Dis Sci 2004;49:546-550. da Rosa Utiyama SR, da Silva Kotze LM, Nisihara RM, Carvalho
  28. RF, de Carvalho EG, de Sena MG, de Messias Reason IJ. Spect- rum of autoantibodies in celiac patients and relatives. Dig Dis Sci ;46:2624-2630.
  29. Cataldo F, Marino V. Increased prevalence of autoimmune disea- ses in first-degree relatives of patients with celiac disease. J Pediatr Gastroenterol Nutr 2003;36:470-473.
  30. Kuloğlu Z. Çölyak hastalığına eşlik eden otoimmün hastalıklar. Selimoğlu MA. (Ed). Çölyak Hastalığı. 1. Baskı. İstanbul:Logos yayıncılık,2008:85-90.
  31. Özgenç F. Tanıda organ spesifik antikorların yeri. Selimoğlu MA. (Ed). Çölyak Hastalığı. 1. Baskı. İstanbul:Logos yayıncılık,2008:132
  32. Miller DG. Celiac disease with autoimmune haemolytic anemia. Postgrad Med J 1984;60:629-630.
  33. Yaralı N, Demirçeken F, Kondolat M, Ozkasap S, Kara A, Tunç B. A rare condition associated with celiac disease: Evans syndrome. J Pediatr Hematol Oncol 2007;29:633-635.
  34. Altuntaş B, Kansu A, Girgin N. Hepatic damage in gluten sensiti- ve enteropathy. Acta Paediatr Jpn 1998;40:597-599.
  35. Uğraş M, Okkabaz N, Ertem D. Çölyak hastalığının tedavisi, glu- ten kontaminasyonu ve yulaf bilinmezi. Selimoğlu MA. (Ed). Çöl- yak Hastalığı. 1. Baskı. İstanbul:Logos yayıncılık,2008:163-174.

Copyright and license

How to cite

1.
Kondolot M, Demirçeken F, Ertan Ü. 52 CASES WITH CELIAC DISEASE IN TURKISH CHILDREN. Turk J Pediatr Dis [Internet]. 2009 Dec. 1 [cited 2025 May 24];3(1):10-7. Available from: https://turkjpediatrdis.org/article/view/48