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.

scholarly journals Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Golnaz Ghazizadeh Esslami ◽  
Bahar Allahverdi ◽  
Reza Shervin Badv ◽  
Morteza Heidari ◽  
Nahid Khosroshahi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Serological Test ◽  
Venous Blood ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Intractable Epilepsy ◽  
Underlying Disease ◽  
Growth Disorders ◽  
Serological Tests ◽  
Cross Sectional

Background. Celiac disease is the inflammatory entropy caused by hypersensitivity to gluten, which occurs in susceptible individuals. Some studies have suggested a link between celiac disease and epilepsy in children. Our aim was to screen for clinical and paraclinical features of celiac disease in children with intractable epilepsy. Methods. This was a cross-sectional study. Children aged 2 to 18 years with refractory epilepsy that referred to the pediatric neurology clinic within one year (2018–2019) were enrolled. Demographic and clinical characteristics of patients, especially clinical manifestations of celiac disease, were recorded in a questionnaire. A venous blood sample was sent to determine the total IgA, anti-tTG (IgA), and anti-endomysial antibody (IgA). Endoscopy was performed in cases where the celiac serological test was positive. Results. Seventy children with idiopathic drug-resistant epilepsy (44 boys) were evaluated. The height-for-age index was 49.2% and the weight-for-age index was 38.2% less than normal. Constipation (48.6%), anorexia (25.7%), and abdominal pain (21.4%) were the most common gastrointestinal symptoms. Celiac serological tests were negative in all children. Therefore, endoscopy and bowel biopsy were not performed in any case. Conclusion. Celiac disease was not found in any patient with intractable epilepsy. Gastrointestinal symptoms and growth disorders in this group may be related to the underlying disease or medications and not to celiac disease.

Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Wide Spectrum ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

Prevalencia de mucosa gástrica heterotópica cervical y su relación con síntomas de reflujo gastroesofágico. Estudio observacional

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Natalia Marina Zeytuntsian ◽  
José Tawil ◽  
Ana Adet Caldelari ◽  
Álvaro Falzone ◽  
Patricio Sheridan ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Clinical Manifestations ◽  
Heterotopic Gastric Mucosa ◽  
Extraesophageal Reflux ◽  
Cross Sectional ◽  
Reflux Symptoms ◽  
Throat Clearing ◽  
Extraesophageal Symptoms ◽  
The Mean ◽  
Upper Gastrointestinal

Introduction. The heterotopic gastric mucosal patch or inlet patch is the presence of gastric columnar mucosa outside the stomach, most frequently located in the proximal esophagus. Its manifestations vary from esophageal and extraesophageal reflux symptoms to major complications, most of them being asymptomatic. Aim. To determine the prevalence of cervical heterotopic gastric mucosa in our environment and its association with esophageal and extraesophageal reflux symptoms. Material and methods. Prospective cross-sectional and observational study; consecutive patients who came to our institution between December 2018 and October 2019 for diagnostic upper gastrointestinal videoendoscopy were included, following a questionnaire on clinical manifestations. Results. A total of 1,408 patients were included. In 89 (6.3%), a cervical heterotopic gastric mucosal patch was described. The mean age of the patients without this condition was 54.6 and 55.5 in patients with it. The esophageal symptoms of gastroesophageal reflux (heartburn, regurgitation, and chest pain) in patients with cervical heterotopic gastric mucosa was observed in 40 (44.9% / p = 0.473), 12 (13.5% / p = 0.783) and 4 (4.5% / p = 0.199) patients respectively. The presence of extraesophageal symptoms (globus, chronic cough, dysphonia, and throat clearing) in patients with cervical heterotopic gastric mucosa was: 9 (10.1% / p = 0.011); 7 (7.9% / p = 0.155); 4 (4.5% / p = 0.458) and 9 (10.1% / p = 0.036) respectively. Conclusions. A statistically significant association was found between the presence of cervical heterotopic gastric mucosal patch and symptoms of globus (p = 0.011) and throat clearing (p = 0.036). It could be interpreted that this group of patients would benefit from the research and treatment of this condition with the intention of improving their symptoms.

scholarly journals Prevalence of zinc deficiency among primary school children in a poor peri-urban informal settlement in South Africa

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Folake O. Samuel ◽  
Abdulkadir A. Egal ◽  
Wilna H. Oldewage-Theron ◽  
Carin E. Napier ◽  
Christine S. Venter
Keyword(s):  
Social Sciences ◽  
South Africa ◽  
Zinc Deficiency ◽  
Informal Settlement ◽  
Serum Zinc ◽  
Primary School Children ◽  
World Health ◽  
Food Sources ◽  
Cross Sectional ◽  
The Mean

This cross-sectional study assessed the risk of zinc deficiency in randomly selected children, aged between 7 and 11 years, living in a poor, peri-urban informal settlement in South Africa. Dietary intake of 149 respondents was evaluated by 24-hour recall and quantitative food frequency questionnaires. Anthropometric and biochemical indices of a subset of 113 were determined. Descriptive statistics, analysis of variance and Pearson correlations were computed using the Statistical Package for Social Sciences, version 14.0. Anthropometric data were analysed using the World Health Organization Anthro plus version 1.0.2 statistical software. Dietary data were analysed with FoodFinder® version 3. The mean age of the children was 9.0±1.1 years. Few zinc-rich sources appeared in the diet that was predominantly plant-based. Mean dietary zinc intake was 4.6±2.2 mg/day. The mean value of serum zinc was 66.4±21.5 µg/dL, with 46% of the children having values less than the 70 µg/dL cut-off. The findings indicate a high risk of zinc deficiency and suboptimal zinc status for the majority of this study population of children, possibly as a result of low consumption of food sources with high bioavailability of zinc, which invariably is a direct consequence of poverty and food insecurity.OpsommingDie doel van hierdie dwarsdeursnitstudie was die bepaling van die risiko van ’n sinktekort in ’n ewekansige steekproef van 7 tot 11 jaar-oue kinders, woonagtig in ’n arm, voorstedelike informele woonbuurt in Suid Afrika. Dieetinnames van 149 respondente is geëvalueer deur 24-uur herroep en kwantitatiewe voedselfrekwensie vraelyste. Antropometriese en biochemiese indikatore van ’n kleiner steekproef van 113 is ook bepaal. Beskrywende statistiek, analise van variansie en Pearsonkorrelasies is bepaal deur die Statistical Package for Social Sciences, uitgawe 14.0. Antropometriese data is geanaliseer deur die statistiese program, Anthro plus, uitgawe 1.0.2, van die Wêreld Gesondheid Organisasie. Dieetdata is met behulp van FoodFinder® uitgawe 3 geanaliseer. Die gemiddelde ouderdom van die kinders was 9.0±1.1 jaar. Min sinkryke voedselbronne is in die hoofsaaklik plantryke dieet waargeneem. Die gemiddelde sinkinname was 4.6±2.2 mg/dag en die gemiddelde serumsinkwaarde was 66.4±21.5 µg/dL, met 46% van die kinders se waardes onder die 70 µg/dL afsnypunt. Die bevindings dui op ’n hoë risiko vir sinktekort en suboptimale sinkstatus vir die meerderheid van hierdie kinders, moontlik as gevolg van die swak inname van voedselbronne met hoë biobeskikbare sink, wat gewoonlik ’n direkte gevolg van armoede en huishoudelike voedsel insekuriteit is.

scholarly journals Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Vital Signs ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Northern Iran ◽  
Laboratory Findings ◽  
Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

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 &gt;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 Time Intervals From Onset of Clinical Manifestations to Treatment in Patients With Cancer at Hospital General San Felipe, Tegucigalpa, Honduras

2019 ◽  
pp. 1-7
Author(s):  
José A. Sánchez ◽  
Mayra G. Handal ◽  
Juan F. Vílchez Rodriguez ◽  
Sinthia I. Mejía ◽  
Annye P. Pagoaga
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Time Interval ◽  
Pathology Report ◽  
Time Intervals ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
The Mean ◽  
Mean Time

PURPOSE In cancer, clinical staging is related to outcomes, and this is linked to the evolution of the disease over time. In Honduras, cancer mortality is high, and time intervals from onset of symptoms to treatment of cancer are not known. We conducted a cross-sectional study to determine these intervals. PATIENTS AND METHODS This investigation was carried out from April 25 to August 30, 2018, and included 202 patients at the main cancer referral center in Honduras. For the purposes of the study, information was obtained from patients, their caregiver, medical records, or treatment cards. Patients older than age 18 years were included after informed consent was signed. RESULTS The mean time interval from onset of symptoms to cancer treatment was 232 days. Different intervals of time were identified, and the mean of these intervals was calculated in days as follows: 68 days from onset of symptoms to first medical evaluation; 146 days from first evaluation to oncologist consultation; 26 days from cancer specialist to the pathology report; and 86 days from the histopathologic diagnosis to the beginning of treatment. Once diagnosis was established, the average elapsed times to chemotherapy, radiotherapy, surgery, and chemoradiotherapy were 88, 102, 76, and 154 days, respectively ( P < .05, when surgery is compared against chemotherapy and radiotherapy). CONCLUSION The mean time interval from symptom presentation to treatment in patients with cancer is more than 7 months. This could explain the advanced stages of disease seen at the time of treatment in Honduras, which decrease chance of cure and increase the mortality rate of cancer). Appropriate intervention to decrease these intervals must be taken to reduce mortality.

Extraintestinal Manifestations of Celiac Disease

2015 ◽  
Vol 33 (2) ◽  
pp. 147-154 ◽  
Author(s):  
María Inés Pinto-Sánchez ◽  
Premysl Bercik ◽  
Elena F. Verdu ◽  
Julio C. Bai
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
High Risk ◽  
Dermatitis Herpetiformis ◽  
Gastrointestinal Symptoms ◽  
Iga Deficiency ◽  
Case Finding ◽  
Aggressive Approach ◽  
Wide Range

Case finding for celiac disease (CD) is becoming increasingly common practice and is conducted in a wide range of clinical situations ranging from the presence of gastrointestinal symptoms to failure to thrive in children, prolonged fatigue, unexpected weight loss and anemia. Case finding is also performed in associated conditions, such as autoimmune thyroid disease, dermatitis herpetiformis and type 1 diabetes, as well as in patients with irritable bowel syndrome, unexplained neuropsychiatric disorders and first-degree relatives of patients with diagnosed CD. This aggressive active case finding has dramatically changed the clinical characteristics of newly diagnosed patients. For instance, higher numbers of patients who present with extraintestinal symptoms are now being diagnosed with CD. Current recommendations state that due to a high risk for complications if the disease remains undiagnosed, patients with extraintestinal symptoms due to CD require appropriate diagnosis and treatment. Despite criticism regarding the cost-effectiveness of case finding in CD, such an aggressive approach has been considered cost-effective for high-risk patients. The diagnosis of CD among patients with extraintestinal symptoms requires a high degree of awareness of the clinical conditions that carry a high risk for underlying CD. Also, understanding the correct use of specific serology and duodenal histology is key for an appropriate diagnostic approach. Both procedures combined are able to confirm diagnosis in the vast majority of cases. However, in certain circumstances, serology and even duodenal histology cannot confirm or rule out CD. A common cause of negative IgA serology is IgA deficiency. For such eventuality, IgG-based serological tests can help confirm the diagnosis. Importantly, some histologically diagnosed cases still remain seronegative despite exclusion of IgA deficiency. On the other hand, duodenal histology may be normal despite the presence of CD-specific antibodies and active CD. This has been clearly demonstrated in some cases of untreated dermatitis herpetiformis, but may also be due to the patchy condition of CD or lesions that are not adequately recognized by nonexpert endoscopists and/or pathologists. The effectiveness of agluten-free diet depends on the clinical end point addressed. A good example is the outcome of bone loss. While risk for fracture normalizes after the first year of dietary treatment, bone parameters measured by densitometry may not be normalized in the long-term follow-up. Moreover, it is still unclear how far an early gluten-free diet will positively affect associated autoimmune diseases like type 1 diabetes and autoimmune thyroiditis.

scholarly journals Evaluation of Iodine in Distributed Salts in Abarkouh City in 2017-2018

2018 ◽  
pp. 659-665
Author(s):  
Mahrokh Mahrokh Jalili ◽  
Ali Asghar Ebrahimi ◽  
Mohammad Hassan Ehrampoush ◽  
Fariba Abbasi ◽  
Eslami Hadi Eslami ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Random Sampling ◽  
Clinical Manifestations ◽  
Iodine Concentration ◽  
T Test ◽  
British Pharmacopoeia ◽  
Wide Range ◽  
Significant Difference ◽  
The Mean ◽  
The City

Introduction: Iodine deficiency and associated disorders, which lead to a wide range of clinical manifestations, have been raised as one of the health and nutritional problems in Iran. Therefore, this study was aimed to investigate the amount of iodine in distributed salts in Abarkouh city in 2017-2018. Materials and Methods: Random sampling was done by census on all 30 distributed brands in Abarkouh city in the different stores across the city. Sixty samples (30 samples after one month from the production date and 30 samples after 6 months from the production date) were collected and transferred to the laboratory. The measurement of iodine was done according to the British Pharmacopoeia recommended method. T-test was used to analyze the data. Results: The Mean iodine concentration in the salts supplied in the Abarkouh was 29.83 ± 19.9 ppm, which was 50% less than the Iran's standard, with a statistically significant difference (P ≤ 0.001). 66.6% of the studied brands did not contain adequate iodine. Six months after production date, the average iodine amount in salts was reduced to 24.26 ± 16.94 ppm, but the reduction was not statistically significant (P = 0.224). Conclusion: Average iodine amount in most of the salts supplied across the Abarkouh city was not acceptable and some salts lacked iodine. Therefore, careful and continuous supervision and monitoring the process of iodized salts production in factories is recommended.

scholarly journals Evaluation of adult celiac disease from a tertiary reference center: a retrospective analysis

2020 ◽  
Vol 66 (1) ◽  
pp. 55-60
Author(s):  
Omer Burcak Binicier ◽  
Ferahnaz Tosun
Keyword(s):  
Celiac Disease ◽  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Gastrointestinal Symptoms ◽  
Single Type ◽  
Adult Celiac Disease ◽  
Antibody Positivity ◽  
The Mean ◽  
Time Of Admission

SUMMARY OBJECTIVE It has been observed that celiac disease (CD) is not restricted to a single type characterized by diarrhea but also has atypical, asymptomatic (silent), and latent forms. The prevalence of this autoimmune disease, which affects approximately 1% of the world, is estimated to be around 3%, including atypical and asymptomatic cases. In our study, we aimed to evaluate adult celiac patients. METHODS Between December 2008-2015, patients diagnosed with CD over the age of 18 years old were included in the study. Patients’ symptoms at admission, frequency and type of anemia, transaminase levels, and celiac antibody positivity, and autoimmune diseases diagnosed at follow up were evaluated retrospectively. RESULTS Of 195 patients, 151 (77.4%) were female. The mean age of the patients was 35.73 ± 12.19 years (range, 18-71 years). A hundred patients (51.3%) had gastrointestinal symptoms. At the time of admission, 118 patients (60.5%) had anemia, and 52 (26.7%) had hypertransaminasemia. During the mean follow-up period of 58 months (36-120 months), 84 (43.1%) of the patients presented at least one autoimmune disease, and this rate was 96.6% in individuals diagnosed above the age of 50 years. CONCLUSION In adult CD, resistant anemia, dyspepsia, and hypertransaminasemia are very common findings at the time of diagnosis, and the association with other autoimmune diseases, especially Hashimoto’s thyroiditis, is high.

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