scholarly journals Psychosocial impairment in children with Celiac disease.

2021 ◽  
Vol 28 (10) ◽  
pp. 1484-1488
Author(s):  
Erum Afzal ◽  
Aslam Sheikh ◽  
Ghazi Khan Khosa ◽  
Komal Noor

Objective: To determine the frequency of psychosocial impairment in patients with celiac disease. Study Design: Descriptive Cross Sectional study. Setting: Children Hospital Complex and Institute of Child Health, (CHICH) Multan. Period: August 2019 to August 2020. Material & Methods: A total number of 177 patients having age 4-16 years with diagnosis of CD were included in this study. In children with CD depressive illness were assessed by using Pediatric symptoms checklist (PSC) form and this PSC form was filled by asking questions from parents then filling of form by doctor. Outcome variable was calculated on the basis of Pediatric symptoms checklist (PSC), whether patient has psychosocial illness or not. Results: Mean age of patients was 8.91±3.50 years. Mean duration of celiac disease of patients was 4.27±2.00 months. There were 135 (76.27%) female patients and 42 (23.73%) male patients. Mean serum anti-tissue transglutaminase IgA (tTG-IgA) level of patients was 122.73±24.31 µg/ml. The socioeconomic status of 115 (64.97%) patients was poor, 31 (17.51%) was middle, 18 (10.17%) patient was upper middle and 13 (7.34%) patients was high. Psychosocial illness was present in 35 (19.77%) patients. Conclusion: Psychosocial illness was diagnosed in 19.77% children having CD. So the children with celiac disease should be monitored for symptoms of anxiety and depression and a thorough counselling of the children to reduce the risk of psychosocial illness.

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Ider Oujamaa ◽  
Majda Sebbani ◽  
Lahcen Elmoumou ◽  
Aïcha Bourrahouate ◽  
Rabiy El Qadiry ◽  
...  

Objective. We aimed to determine the prevalence of specific auto-antibodies to celiac disease (CD) in Moroccan type 1 diabetic (T1D) patients and compare the clinical and biological characteristics of seropositive and seronegative cases. Patients and Methods. A cross-sectional study was carried out on 276 T1D patients including 109 adults and 167 pediatric cases. The screening for CD was performed by an Elisa IgA anti-tissue transglutaminase antibody (tTGA) testing, combined with IgA quantification by nephelometry. Positive-IgA-tTGA cases were secondly tested for anti-endomysial antibodies (EMA) using an immunofluorescence technique, and the IgA deficiency cases were screened for IgG-tTGA. Patients with low positive tTGA titers underwent HLA-DQ2/DQ8 typing. Sociodemographic and clinical data of the patients were collected using a hetero-administered questionnaire. The comparison of clinical and biological data between seropositive and seronegative diabetics was done using independent T, Mann–Whitney U, chi-squared, and Fisher tests, which were considered significant if p value <0.05. Results. The prevalence of CD-specific auto-antibodies was estimated to be 9.1% (IC = 95%), with 25 positive cases in tTGA and EMA testing. Eight cases displayed low titers of IgA-tTGA, among which 4 were positive for HLA-DQ2, 1 for HLA-DQ8, and 1 for both DQ2 and DQ8. The other 2 cases had a biopsy-proven CD. Compared to seronegative patients, seropositive cases had a higher percentage of associated autoimmune disorders (16% vs. 2.4%, p=0.008), with a significant lower height Z-scores (median: −0.90 (−3.93 to 0.95) vs. −0.51 (−4.54 to 2.18), p=0.029) and a higher HbA1c level (median: 11.30% (7.31 to 16.00) vs. 9.30% (4.40 to17.31), p=0.022). Conclusion. The current study gave evidence of a high prevalence of CD specific auto-antibodies in T1D population. The co-existence of these two conditions was associated with a poor glycemic control, a lower height, and other autoimmune diseases. These findings may suggest the necessity of a systematic screening of CD in T1D patients.


2020 ◽  
Author(s):  
Adam Miraj Gembe

Abstract Background: Global prevalence of irritable bowel syndrome is high among medical students and health care professionals with significant morbidity. Similarly, the prevalence of celiac disease in irritable bowel syndrome is higher than the general population. These conditions impair quality of life and contribute to social-economic burden. In Tanzania, little is known about irritable bowel syndrome and celiac disease among medical students and health care professionals. Methods: A cross sectional study was conducted to MUHAS and Mloganzila Academic Medical Center (MAMC) staff and students who fulfilled the online shared Rome IV criteria of irritable bowel syndrome from August to November 2018. A structured questionnaire was used to collect socio-demographic data, anthropometric measurements and clinical manifestations. Blood samples for full blood picture, liver enzymes and Erythrocyte Sedimentation Rate were taken. Celiac disease was tested using anti-tissue transglutaminase antibody test. Qualitative and quantitative data were summarized using frequency distribution tables. Chi-square and fishers exact test were used to study comparison between groups. Logistic regression was used to study associations. Data was analyzed using SPSS version 20.0 and a P value of ≤0.05 was considered significant.Results: Out of 1,321 participants, 192 (14.5%) had irritable bowel syndrome in which 77 (40.1%) were males and 115 (59.9%) were females. Among the 192 participants with irritable bowel syndrome, 3 (1.6%) were positive for celiac disease, 2 (66.7%) were females and 1 (33.3%) was a male. Of the 3 patients with CD, 2 had elevated ALAT and 1 had anaemia. Age (AOR 2.53, 95% C.I 1.57-4.09), sex (AOR 1.67, 95% C.I 1.16-2.41), marital status (AOR 4.95 C.I 2.07-11.82), alcohol intake (AOR 2.47, 95% C.I 1.16-5.23), year of study (AOR 8.49, 95% C.I 5.71-12.64) and sleep duration (AOR 2.24, 95% C.I 1.23-4.06) were found to be independently associated with IBS. Conclusion: Prevalence of IBS and its associated factors in our study population was similar to findings from studies done elsewhere. Also, our study revealed a low prevalence of celiac disease among IBS participants.


2019 ◽  
Vol 6 (5) ◽  
pp. 1855
Author(s):  
Jasraj Bohra ◽  
Virendra K. Gupta ◽  
Ashok Gupta

Background: Celiac disease (CD) is a genetically determined gluten-sensitive enteropathy resulting in nutrient malabsorption, can have extra gastrointestinal tract (GIT) presentations, short stature may be the only presenting clinical feature, even in the absence of gastrointestinal symptoms. The aim and objective of this study was toMethods: This cross-sectional study was performed on 1000 children between ages 5 to 10 year of different schools, in Jaipur, district of Rajasthan. An anthropometric measurement (height, weight) was done for all children. Serum samples were analyze for IgA antibodies to human tissue transglutaminase (tTG) with lower detection limit of 1.0 U/ml and 15 U/ml. Positive samples for tTG antibodies were reanalyzed human endomysial autoantigens (EmA).Results: Out 1000 children screened, six were seropositive, of those four were females and two were males. The serological proportion of CD in this population was 1:166. These Six seropositive group tends to have lower height, weight than the seronegative group, but the difference was only significant for height (P=<0.01).Conclusions: Although gastrointestinal manifestations are important presentation of celiac disease, nevertheless short stature alone or in combination with other symptoms of celiac disease has been present.


Author(s):  
YM Bhavika ◽  
DG Prasanna Kumar ◽  
HN Harish

Introduction: Celiac disease is a chronic gastrointestinal disorder, very often underdiagnosed due to lack of awareness among the general practitioners. Aim: To study the prevalence of celiac disease among children with chronic diarrhoea. Materials and Methods: A cross-sectional study was conducted in which, 890 children between the age group of 1-18 years with history of chronic diarrhoea (loose stools or increased frequency for more than two weeks) were enrolled, between November 2015 and January 2018 in a tertiary care centre in India. The children were screened with serological tests for celiac disease and among those who were tested positive; the diagnosis was confirmed by intestinal biopsy. Results: Of the 890 patients with chronic diarrhoea, 252 (28.3%) were tested positive for anti-tissue Transglutaminase (tTG) antibodies with levels more than 10 times the upper normal limit. Among the 252 patients with positive serology, 144 patientshad intestinal biopsy findings suggestive of celiac disease (Marsh stage 3b and 3c) while the rest had normal or mild (marsh grade 1, 2 and 3a) histological changes. Conclusion: Celiac disease is one of the most important causes of chronic diarrhoea and hence should be actively looked for in children presenting with chronic diarrhoea.


Author(s):  
Günsel Kutluk ◽  
Hafize Emine Sönmez ◽  
Hülya Kaçmaz

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children characterized by autoimmune etiology. In previous studies, increased Celiac disease (CD) frequency was reported in patients diagnosed with JIA. In this study, CD and non-celiac gluten sensitivity (NCGS) in patients diagnosed with JIA were investigated. METHODS: Sixty-one (57.3%) JIA patients admitted to the pediatric rheumatology outpatient clinic between January 2020 and April 2020 were included in this cross-sectional study. All patients were evaluated with clinical and laboratory findings in terms of CD and NCGS. Total immunoglobulin (Ig)-A, tissue transglutaminase antibody (tTG) IgA and IgG, anti-endomysium-antibody (EMA) IgA and IgG and anti-gliadin-antibody (AGA) IgA and IgG levels were measured in all patients. RESULTS: Sixty-one JIA patients, 35 girls, were included in the study. The mean age of the patients was 11.4 ± 4.6 years, the mean age at diagnosis is 10.2 ± 3.4 years. Thirty-three patients were diagnosed with oligoarticular JIA; 18 patients with enthesitis-related arthritis, 8 patients with polyarticular JIA, and 2 patients with psoriatic arthritis. All patients were using disease-modifying antirheumatic drugs during the study. Thirty-five patients were receiving biological therapy, concomitantly. Two patients had abdominal pain, two patients had indigestion, and two patients had constipation. None of the patients had growth retardation. EMA IgA and IgG, tTG IgA and IgG, AGA IgA and IgG tests were negative in all patients. DISCUSSION AND CONCLUSION: CD and NCGS were not detected in our JIA patients. Multi-center studies may guide clinicians in under what circumstances to perform CD and NCGS screening in JIA patients.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Pezhman Alavinejad ◽  
Hajieh Bibi Shahbazian ◽  
Alireza Jahanshahi ◽  
Mohamad Faramarzi ◽  
Zahra Shokati Ashkiki

Background: The association of celiac disease (CD) with refractory hypothyroidism is a known but less common condition. Objectives: This study aimed to evaluate the prevalence of CD among patients with refractory hypothyroidism and compare the accuracy of different diagnostic procedures of CD in these patients. Methods: During a six-month period, 25 patients with refractory hypothyroidism were included from the endocrinology outpatient clinics of Ahvaz Jundishapur University of Medical Sciences, Khuzestan, Iran. For all the participants, the serological profile of CD, including anti-tissue transglutaminase (anti-tTG), anti-endomysial antibody (anti-EMA), and total immunoglobulin A, was determined, and then they were referred to undergo upper endoscopy and random biopsies from the first and second parts of the duodenum. Results: The average duration of hypothyroidism among the participants was 7 months. In addition, 75% of the patients (n = 19) were female. The mean age values of male and female subjects were 31.3 ± 17 and 34.3 ± 8.5 years, respectively (age range: 17 - 53 years). The average daily dosage of levothyroxine was 285.1 ± 89.9 mg. The most common comorbidities were anemia (72%) and diarrhea (24%). The most frequent serologic findings in these patients were positive anti-tTG (28%) and anti-EMA (16%). The most common results of upper endoscopy were normal mucosa (48%), gastritis (28%), duodenal fissuring (8%), duodenal atrophy (8%), and duodenal erythema (8%). Based on the results of the pathology report, 20% of the patients (n = 5) were diagnosed with CD (mostly marsh 1 and 0 stages). The sensitivity and specificity of tTG were 33 and 87.5%, respectively. The sensitivity and specificity of EMA were 11.1 and 87.5%, respectively. Conclusions: Based on the results of this pilot study, the prevalence of CD among cases with refractory hypothyroidism is higher than that of global reports. Furthermore, routine screening of CD in these patients is highly recommended even with negative serology. The endoscopic view is not adequate for the diagnosis of CD among patients with refractory hypothyroidism. In addition, it is necessary to focus on pathology reports and antibody titer.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zahra Setavand ◽  
Maryam Ekramzadeh ◽  
Naser Honar

Abstract Background Celiac Disease (CD) is an autoimmune systemic disorder triggered by gluten in genetically susceptible individuals, which can lead to chronic malabsorption. Considering the changes in the manifestations of CD, this study aimed to determine anthropometric indices and clinical indications in children with CD. Methods This cross-sectional study aimed to evaluate the children with CD who had referred to Imam Reza Celiac Clinic between 2016 and 2019. Totally, 361 children were eligible and their anti-tissue transglutaminase (TGA-IgA) level, weight, height, and Body Mass Index (BMI) were extracted from their records. The anthropometric indices were presented based on the criteria of the Center for Disease Control and Prevention (CDC) and World Health Organization (WHO). The prevalent symptoms were assessed, as well. Results Based on the CDC’s criteria, 18.3, 28.8, and 25.8% of the children had short stature, low body weight, and low BMI, respectively. These measures were obtained as 10, 22.4, and 13.9% according to the WHO’s categorization respectively. Furthermore, the most common symptoms among the children were abdominal pain (56.5%), skeletal pain (28%), constipation (27.4%), and anemia (23.8%). Conclusion To sum up, the results clearly indicated that growth failure and low height, weight, and BMI were prevalent among the children with CD. Moreover, in addition to gastrointestinal symptoms, a considerable number of patients had skeletal pain and anemia.


2021 ◽  
pp. 247412642198922
Author(s):  
Brittany C. Tsou ◽  
T.Y. Alvin Liu ◽  
Jun Kong ◽  
Susan B. Bressler ◽  
J. Fernando Arevalo ◽  
...  

Purpose: This work evaluated the use and type of dietary supplements and home monitoring for nonneovascular age-related macular degeneration (AMD), as well as the prevalence of genetic testing among patients with AMD. Methods: A cross-sectional study was conducted of 129 participants older than 50 years who completed self-administered questionnaires regarding usage and type of dietary supplements and home monitoring, as well as the participants’ use of genetic testing for AMD. Results: Of 91 participants with AMD, 83 (91.2%) took vitamins, including 55 (60.4%) who used an Age-Related Eye Disease Study (AREDS) or AREDS2 formulation. Of 38 without AMD, 31 (81.6%) took vitamins (difference from participants with AMD = 9.6% [95% CI, 0%-23.2%]), including 2 on an AREDS formulation. Among 82 participants with AMD who were AREDS candidates (intermediate or advanced AMD in 1 or both eyes), 51 (62.2%; 95% CI, 51.7%-72.7%) took an AREDS or AREDS2 formulation, and 31 (37.8%) did not (5 were unsure). Additionally, 50 (61.0%; 95% CI, 50.4%-71.6%) AREDS candidates did some type of home monitoring. Only 1 (1.2%; 95% CI, 0%-3.6%) underwent genetic testing for AMD. Among 9 with AMD who were not AREDS candidates, 4 (44.4%) used an AREDS formulation, 4 (44.4%) did not, and 1 (11.1%) was unsure; only 1 (11.1%) of these 9 performed home monitoring. Conclusions: Despite similar results from past surveys and AREDS2 data supporting supplement use in 2013 and home monitoring in 2014, these findings suggest about one-third of AREDS candidates do not do so, providing further support for improving education regarding appropriate supplement and home monitoring usage. Genetic testing for AMD also appears infrequent.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045992
Author(s):  
Eugene Budu ◽  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Abdul-Aziz Seidu ◽  
...  

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.


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