P031 Adherence with Methotrexate in Tunisian Juvenile Idiopathic Arthritis Patients

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Hiba Bettaieb ◽  
Wafa Triki ◽  
Kaouther Maatallah ◽  
Hanene Ferjani ◽  
Dorra Ben Nessib ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Disease Duration ◽  
Pediatric Population ◽  
Demographic Data ◽  
Disease Onset ◽  
Weekly Dose ◽  
Cross Sectional ◽  
High Adherence ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in the pediatric population. Methotrexate (MTX) has been considered as the cornerstone of treatment of poly and oligoarticular subtypes of JIA. However, this treatment is supposed to be for long term, which may involve an obstacle for adherence. The aims of the study were to evaluate adherence of Tunisian JIA patients to MTX and to identify factors associated with high adherence to MTX. Methods A cross-sectional study including patients with confirmed JIA diagnosis, according to the International League of Associations for Rheumatology (ILAR) criteria, was performed. Demographic data as well as disease characteristics were obtained from medical records. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. Adherence was measured, for patients under MTX for >3 months, using the 5-item Compliance Questionnaire Rheumatology (CQR5) (1). Patients were divided into two groups: group 1: High adherence (HA) for patients having a CQR5 ≥ 80% and group 2: low adherence (LA) for patients having CQR5 < 80%. A p inferior to 0.05 was considered statistically significant. Results The study included 29 patients (10 males and 19 females) with a mean age at disease onset of 9.1 ± 3.4 years. The mean disease duration was 61 ± 79 months [7–336]. JIA subtypes were in decreasing order of frequency as follows: enthesitis-related arthritis (n = 13), oligoarticular (n = 8), Polyarticular without rheumatoid factor (n = 4), Polyarticular with rheumatoid factor (n = 2), systemic (n = 1) and, psoriatic arthritis (n = 1). A biologic inflammatory syndrome was found in 48.3% (n = 14) of cases. The mean ESR and CRP were 20 mm/h ± 11.3 [3–98] and 5 ± 17.8 mg/l [0–56] respectively. Nineteen (65.5%) patients had coxitis. Overall, 55.17% of patients (n = 16) were treated with MTX with a mean weekly dose of 9.2 ± 3.2 mg [5–15]. MTX was orally administrated in all patients. NSAIDs and prednisone were prescribed in 51.7% (n = 15) and 17.2% (n = 5) of cases respectively. The MTX was associated with biological DMARDs in five patients (17.2%). It was about Etanercept in 4 patients and Tocilizumab in 1 patient. Mean CQR5 score was 70.8% ± 18 [25–100]. Only seven patients (43.8%) showed high adherence to MTX. The statistical study revealed no difference between HA and LA in term of gender (P = 0.84), age at disease onset (P = 0.39), disease duration (P = 0.9), prednisone use (P = 0.22), the occurrence of coxitis (P = 0.2), ESR (P = 0.83) and CRP (P = 0.033) rates. Conclusion In this study, less than one half of JIA patients were highly adherent to MTX according to CQR5. Low adherence should be considered before declaring MTX treatment failure.

P019 Adulthood of juvenile idiopathic arthritis patients: professional outcome

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
S Bouzid ◽  
A Fazaa ◽  
L Souabni ◽  
M Sellami ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
College Graduates ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
Full Time ◽  
Family Status ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
The Mean ◽  
Professional Outcome

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of rheumatic diseases characterized by onset before the age of 16. Since the disease starts at an early age, it may lead to socio-professional difficulties in adulthood for JIA patients. This study aimed to describe the professional outcome of a series of 20 JIA patients. Methods A cross-sectional study including patients aged 20 years and more and fulfilling the ILAR criteria for the diagnosis of JIA was carried out. Telephone interviews were conducted. The responders answered questions about family status, current occupation, working h, eventual workplace adjustments, and sick leave frequency. Results Twenty patients answered the questionary; 14 males and 6 females. The mean age of the disease onset was 8 years. The mean age of patients at the time of the study was 24.27 years [20–36]. Polyarticular form was the most frequent (10 cases). Other subtypes diagnosed were systemic (4 cases), enthesitis-related arthritis (5 cases), oligoarticular (one case). Hip arthritis was observed in 8 patients and surgical intervention was needed in three. Eight patients were treated with csDMARDSs and 12 with bDMARDs. Three of our patients were married (aged 24, 34, and 36). Five were still studying: 4 had good grades without absenteeism. However, one patient needed special aid to go to school and had a higher absence rate. Five other patients were full-time college students without absenteeism. Four patients were college graduates. Among them, two were searching for a job for >6 months. The other two were full-time administrative workers with no absenteeism. One patient did need workplace adjustments. Six patients could not work because of their physical disabilities. Conclusion According to our results, a quarter of our patients could not access professional life. Disease activity and hip destruction are the two main factors causing JIA patients to miss out on important personal and professional opportunities.

scholarly journals Challenge and hope for parents who have cancer

2021 ◽  
Vol 3 (1) ◽  
pp. 136-147
Author(s):  
Yuko Akagawa ◽  
Sachiko Makabe ◽  
Tomoko Ito ◽  
Yutaka Kimura ◽  
Hideaki Andoh
Keyword(s):  
Disease Duration ◽  
Response Rate ◽  
Demographic Data ◽  
Current Status ◽  
Stress Coping ◽  
Parental Cancer ◽  
Cross Sectional ◽  
Coping Ability ◽  
The Mean ◽  
The Relationship

Parents who have cancer face particular problems in their relationships with children. This study aims to clarify 1) the current status of challenge/hope in parental cancer, 2) the factors related to challenge/hope, and 3) the relationship between challenge/hope and QOL/stress-coping ability. Cross-sectional national survey was conducted at designated cancer hospitals in Japan. Participants were undergoing cancer treatment and have children under 18 years old. The questionnaire included demographic data, QOL, ability to cope with stress, and challenge/hope. From 11 hospitals, 54 patients (response rate: 79.4%) participated. Majority of participants were female (72.2%) with the mean age of 39.3 ± 5.3 (SD). The total score was QOL (FACT-G: 50.4 ± 16.2), stress-coping ability (SOC: 46.7 ± 10.4). The main challenges were an inability to fulfill the parental role and children’s mental suffering due to loneliness. The main aspects of hope were the value of the children’s present self, being a parent, and strengthening family bonds. Gender and disease duration were significantly related with challenge/hope. Challenge was significantly related with QOL/stress-coping ability. Parents who have cancer derive hope from their relationship with their children, although they feel a gap between their ideal role/value as a parent and their current status.

scholarly journals AB0732 JUVENILE IDIOPATHIC ARTHRITIS IN ADULTHOOD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1396.2-1396
Author(s):  
N. Ben Chekaya ◽  
S. Bouden ◽  
A. Ben Tekaya ◽  
O. Ben Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Joint Destruction ◽  
Disease Onset ◽  
Failure To Thrive ◽  
Overweight And Obesity ◽  
Physical Growth ◽  
The Mean ◽  
Active Disease

Background:Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unknown aetiology in childhood. Approximately 40- 60% of patients with juvenile idiopathic arthritis (JIA) have continuous or recurrent disease activity extending into adulthood.Objectives:The aim of this study was to evaluate the clinical, biological and radiological course of JIA in adulthood.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Patients with JIA older than 20 years were included. Data regarding sociodemographic features, Physical growth, disease activity, biological and radiological parameters were analysed.Results:Thirty one patients were recruited. The sex ratio was 0.53. The mean age at the time of the study was 38.9 years [20-69]. The mean age of the disease onset was 9 years [3-16]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (47.7%), rheumatoid factor negative polyarthritis (23.9%), oligoarthritis (14.2%), enthesitis-related arthritis (9.5%), and psoriatic arthritis (4.7%).A failure to thrive was seen in 33.3% of patients. Overweight and obesity were found in 38% and 19% of patients, respectively. Biological inflammatory syndrome was noted in 52% of patients, and 65.2% had active disease. Hip involvement was noted in 43.5% of patients and 17.4% of them had a total hip replacement. Sixteen patients had neck pain and the imagining showed an atloid-axoid dislocation in 50% of them. Radiographs showed a joint destruction in 60.9% of patients and a wrist arthritis was the most frequent involvement.Conclusion:Most of our included patients maintain active disease and have functional impairment in adulthood.Disclosure of Interests:None declared

P017 Complications of Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
S Bouzid ◽  
A Fazaa ◽  
L Souabni ◽  
M Sellami ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Adverse Effects ◽  
Disease Onset ◽  
Clinical Signs ◽  
Membranous Glomerulonephritis ◽  
Cross Sectional Study ◽  
Chronic Inflammatory Disease ◽  
Cross Sectional ◽  
Renal Manifestation ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease characterized by onset before the age of 16. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and prognosis. The study aimed to determine JIA complications in 51 patients. Methods A cross-sectional study including patients diagnosed with JIA according to ILAR criteria was conducted for 26 years [1995– 2021]. Epidemiological, clinical, therapeutic, and evolutive aspects were noted. Results Twenty-nine males and 22 females were included. The mean age of the disease onset was 7.6 years [1,5–16]. The mean age of patients at the time of the study was 23.29 years [9–45]. Polyarticular and seronegative form was the most frequent (34.5%). Other subtypes diagnosed were systemic (25%), enthesitis-related arthritis (21.2%), oligoarticular (12.5%), and seropositive polyarticular (5.8%). Standard X-Ray imaging showed articular damage in 50% of the cases. Hip arthritis was observed in 32% and surgery was needed in 16.9%. One patient presented with atlantoaxial subluxation. Growth retardation was noted in 28.6%. Cardiac manifestations were seen in 3 patients (pericarditis = 2, myocarditis = 1), uveitis in 3 cases, renal manifestation (extra membranous glomerulonephritis) in one patient with polyarticular form. One patient was diagnosed with multiple sclerosis. Small doses of corticosteroids were prescribed in 71.7%. Methotrexate was prescribed in 70.5% (interrupted for adverse effects in 3 patients), sulfasalazine in 30.6%, hydroxychloroquine in 5.7%, leflunomide in 15.4%. bDMARDs were needed in 16 patients: 14 patients received TNF alpha inhibitors, rituximab was prescribed for one patient with a polyarticular form, and tocilizumab in a patient with a systemic form. A switch of bDMARDs was conducted in 10 patients: for inefficiency in 4 cases and adverse effects in other 4 cases. Three patients developed uveitis under Etanercept, septicemia under Adalimumab, an allergic reaction, and depression under Infliximab. One patient died from a convulsive seizure at the age of 9. Conclusion The presence of complications is an additional burden to JIA patients. A multidisciplinary approach is required for the management of these complications.

scholarly journals Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis: 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort

2019 ◽  
Vol 47 (5) ◽  
pp. 730-738 ◽  
Author(s):  
Mia Glerup ◽  
Peter Stoustrup ◽  
Louise H. Matzen ◽  
Veronika Rypdal ◽  
Ellen Nordal ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Demographic Data ◽  
Disease Onset ◽  
Population Based ◽  
Cone Beam ◽  
Biologic Treatment ◽  
Temporomandibular Joints ◽  
Tmj Pain ◽  
The Mean ◽  
Full Face

Objective.To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.Methods.Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.Results.Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.Conclusion.This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.

P032 Methotrexate and hepatic tolerance in Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
Y El Mabrouk ◽  
A Fazaa ◽  
L Souabni ◽  
M Sallemi ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Disease Onset ◽  
Prolonged Treatment ◽  
Hepatic Toxicity ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Pre Treatment ◽  
Seronegative Polyarthritis ◽  
Hepatic Cytolysis

Abstract Background Methotrexate (MTX) is considered as the main treatment for some juvenile idiopathic arthritis (JIA) subtypes. The hepatic toxicity of MTX has been reported in numerous studies in rheumatoid arthritis which have shown that prolonged treatment can induce hepatic fibrosis and a disturbance of the liver biologic tests. In patients with JIA, the potential hepatic toxicity of MTX needs to be confirmed. Methods A retrospective study of patients followed for JIA and treated with MTX was conducted. The results of the hepatic assessment looking for cytolysis or cholestasis performed during the pre-treatment assessment and then during regular checks were noted. Results Thirty-nine JIA patients were included. The mean age of disease onset was 8 years [1.5–17 years]. The JIA subtype was systemic in 11 cases, enthesitis related arthritis in 5 cases, rheumatoid factor seronegative polyarthritis in 15 cases and rheumatoid factor seropositive polyarthritis in 2 cases, and oligoarthritis in 2 cases. Patients were treated with low doses of corticosteroids (0.2–0.4 mg/kg) in majority of cases (82%). Non steroid anti-inflammatory drugs were used in 51% of cases. MTX was prescribed as monotherapy in 20 cases, in combination with Sulfasalazine in 6 cases and Anti TNF alpha in 12 cases. MTX has been used on average for 11 years [2 months-26 years]. This drug was stopped for ineffectiveness in 7 cases, for digestive intolerance in 2 cases and in one case for severe hepatic cytolysis after 2 years of treatment with a progressive normalization of hepatic laboratory tests after 6 months. During regular monitoring, no further disturbances of liver function were observed. Conclusion MTX hepatotoxicity appears to be very mild and rare in JIA. These results are reassuring given that MTX is a highly effective treatment in JIA.

scholarly journals AB0731 CERVICAL SPINE INVOLVEMENT IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1396.1-1396
Author(s):  
S. Bouden ◽  
N. Ben Chekaya ◽  
A. Ben Tekaya ◽  
O. Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cervical Spine ◽  
Rheumatoid Factor ◽  
Disease Onset ◽  
Odontoid Process ◽  
Basilar Invagination ◽  
X Rays ◽  
Radiological Data ◽  
Adult Rheumatoid Arthritis ◽  
The Mean

Background:Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. In contrast to adult rheumatoid arthritis, where numerous studies have shown a high prevalence of involvement of the cervical spine, few studies have been published examining this entity in JIA.Objectives:We aimed to analyze clinical and radiological findings of cervical spine involvement in patients with JIA.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Clinical, biological, and radiological data were collected. Patients had a radiological evaluation that included cervical spine x-rays in antero-posterior, lateral and lateral views with flexion.Results:Thirty-five patients were enrolled. The mean age of the disease onset was 9 years [3-15]. The mean age of the patients at the time of the study was 37.8 years [17-69]. The mean duration of the disease was 27 years [2-56]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (43.5%), rheumatoid factor negative polyarthritis (21.7%), enthesitis-related arthritis (17.4%), oligoarthritis (13%) and psoriatic arthritis (4.4%). Sixteen patients (45%) reported neck pain. Cervical spine involvement occurred on average 7 years [0-13] after the JIA onset. Cervical spine radiographs showed anterior atlantoaxial subluxation (> 5mm) in 8 patients. Magnetic-resonance imagining was performed in 9 patients that had abnormal neurological examination showing a pannus formation of C1-C2 junction (3 cases), a basilar invagination (4 cases) and erosions of the odontoid process (2 cases). A cervical collar has been used for immobilization in patients with significant cervical spine damage. A C1-C2 arthrodesis was proposed to 4 patients.Conclusion:These findings suggest that the presence of cervical involvement in JIA patients is frequent. Radiologic assessment of cervical spine should be systematically performed for early detection and to prevent its complications.Disclosure of Interests:None declared

P020 The male gender predicts the hip involvement among JIA patients

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Makhlouf Yasmine ◽  
Hanene Ferjani ◽  
Wafa Triki ◽  
Kaouther Maatallah ◽  
Dorra Ben Nessib ◽  
...  
Keyword(s):  
Rheumatoid Factor ◽  
Disease Duration ◽  
Age Of Onset ◽  
Disease Onset ◽  
Limited Range ◽  
Male Gender ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Limited Range Of Motion ◽  
Significant Difference

Abstract Background Juvenile idiopathic arthritis (JIA) represents a heterogeneous group of chronic arthritides that affect children aged 16 years and under. Regardless of the clinical presentation, hip involvement ranges between 20% to50% of cases [1]. The aim of the present study was to examine the role of gender and disease onset in coxitis involvement. Methods We conducted a cross-sectional study including children with JIA according to the International League of Associations for Rheumatology (ILAR)). Transcribed data included age, sex and the characteristics of the disease (subtype of JIA, disease duration). Regarding coxitis, we collected radiographs, ultrasound (US) and magnetic resonance imaging (MRI) of the hip when performed. Coxitis was defined by clinical (limited range of motion) and/or radiographic findings (destruction, synovitis, bone marrow oedema). We divided patients into two groups: G1: presence of coxitis and G2: absence of coxitis. Results The study included 62 patients with a male perdominance: sex ratio was 2.3. The mean age of onset of the disease was 11.4 years [3–16]. The frequency of each JIA subset was as follows: polyarticular with rheumatoid factor (n = 2), polyarticular without rheumatoid factor (n = 4), systemic (n = 1), enthesitis-related arthritis (n = 44), oligoarthritis (n = 8), psoriatic arthritis (n = 3). A Hip involvement was reported in 71% of cases and was bilateral in 81% of patients. Coxitis was not correlated with the disease duration (P = 0.7). A positive correlation was found between the age of onset of the disease and the presence of coxitis (12.2 vs 9.6, P = 0.005). However, hip involvement was higher among males without significant difference (76.7% vs 58%, P = 0.132). Conclusion Unlike the literature data, our study showed a high frequency of hip involvement in Tunisian children with JIA. We found an association between the male gender and coxitis involvement without significant difference. However, coxitis was more frequent in later onset of the disease.

scholarly journals AB0730 HIP INVOLVEMENT IN JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1395.3-1396
Author(s):  
S. Bouden ◽  
N. Ben Chekaya ◽  
A. Ben Tekaya ◽  
O. Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Hip Replacement ◽  
Joint Space Narrowing ◽  
Disease Onset ◽  
Joint Space ◽  
Hip Disease ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Inflammatory Syndrome

Background:Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases that have in common an onset before the age of 16 years, more than 6-month duration, and the presence of arthritis for at least 6 weeks with no identifiable cause. Hips are the commonly affected joints in severe destructive JIA. Hip disease develops in 20% to 50% of children with JIA.Objectives:We aimed to analyze the epidemiological, clinical, and radiological aspects of hip involvement in Tunisian JIA.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Clinical, biological and radiological parameters relating to the hip involvement were collected.Results:Thirty-five patients were enrolled. The mean age of the disease onset was 9 years [3-15]. The mean age of the patients at the time of the study was 37.8 years [17-69]. The mean duration of the disease was 27 years [2- 56]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (43.5%), rheumatoid factor negative polyarthritis (21.7%), enthesitis-related arthritis (17.4%), oligoarthritis (13%) and psoriatic arthritis (4.4%). A biological inflammatory syndrome was noted in 52% of patients. Hip involvement was noted in 43.5% of patients. Coxitis occurred on average 15 years after the JIA onset [[4-37]. Thirty four percent of the patients had bilateral hip involvement. The mean Lequesne index was 14. Joint space narrowing and erosions were noted in respectively 68% and 34% of cases. The majority of patients (82.6%) received medical treatment combining nonsteroidal anti-inflammatory drugs (NSAID) and rehabilitation. In the other cases, a total hip replacement was necessary. Coxitis was significantly correlated with rheumatoid factor positive polyarthritis subtype (p=0.02) and with the presence of biological inflammatory syndrome (p=0.03).Conclusion:Hip involvement is a major and highly prevalent issue in our JIA patients.Disclosure of Interests:None declared

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

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