scholarly journals Response of Hepatitis B Vaccine in Children with Celiac Disease – An Experience at Ayub Teaching Hospital, Abbottabad Pakistan

2021 ◽  
Vol 10 (2) ◽  
pp. 95-100
Author(s):  
Bibi Aalia ◽  
Syed Sajid Hussain Shah
Keyword(s):  
Celiac Disease ◽  
Hepatitis B ◽  
Teaching Hospital ◽  
Intestinal Inflammation ◽  
Tissue Transglutaminase ◽  
Tertiary Care ◽  
Hepatitis B Vaccine ◽  
Intestinal Biopsy ◽  
P Value ◽  
Small Intestinal

Background: Celiac Disease (CD), characterized by chronic small intestinal inflammation, is an immune-mediated disorder, with a strong family history and association with DQ2 HLA haplotype. It has been postulated that children with CD show less response to hepatitis B vaccine due to overexpression of HLA-DQ2 haplotype. This study was done to determine the response of hepatitis B vaccine in children with CD in our tertiary care setting in the Hazara region of eastern Khyber Pakhtunkhwa, Pakistan.Material and Methods: This cross-sectional study was conducted in the Pediatrics outpatient department (OPD) of Ayub Teaching Hospital, Abbottabad Pakistan from April 2018 till March 2020. Children with CD (n=38) aged 1-14 years with completed HBV vaccination, anti-tissue transglutaminase IgA antibody (tTG-IgA) >150 IU/ml and/or typical histological findings of CD on small-bowel biopsy, were included in the study. Hepatitis B surface antibody (HbsAb) titer of ≥10 mIU/ml was taken as antibody positive, while HbsAb levels < 10 mIU/ml were considered as vaccine non-responsive. Data was analyzed using SPSS version 20.0. Chi square test was applied for comparison with P-value < .05 taken as significant.Results: Out of 38 diagnosed cases of CD, 15 (39.5%) were males and 23 (60.5%) were females. Mean age of children was 8.32±3.26 years with an age range of 3-14 years. HbsAb levels ranged from 0.10 to 62.7 mIU/ml with a mean of 11.2+17.42 mIU/ml. HbsAb levels were less than 10.0 IU/ml in 73.7% of children with CD. Small intestinal biopsy was performed in 11 (28.9%) patients. There was a significant relationship between anti tTG-IgA levels and histopathology findings with P-value of .001.Conclusions: In children having celiac disease, there was low rate of protective antibody response to hepatitis B vaccine.

scholarly journals Celiac Disease in Children with Chronic Diarrhoea: A Cross-sectional Study

2021 ◽  
Author(s):  
YM Bhavika ◽  
DG Prasanna Kumar ◽  
HN Harish
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Intestinal Biopsy ◽  
Chronic Diarrhoea ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Serological Tests ◽  
Cross Sectional

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.

scholarly journals Serum Markers in the Clinical Management of Celiac Disease

2015 ◽  
Vol 33 (2) ◽  
pp. 236-243 ◽  
Author(s):  
Marlou Adriaanse ◽  
Daniel A. Leffler
Keyword(s):  
Celiac Disease ◽  
Disease Activity ◽  
Patient Care ◽  
Dynamic Range ◽  
Intestinal Inflammation ◽  
Tissue Transglutaminase ◽  
Intestinal Biopsy ◽  
Intestinal Damage ◽  
Fatty Acid Binding ◽  
Serologic Tests

The advent of highly reliable noninvasive celiac diagnostic tests has transformed the field of celiac disease, from diagnosis, to evaluation of epidemiology, to clinical and translational research. Serologic tests in their modern forms are highly sensitive and specific for diagnosis, allowing for consideration of avoidance of diagnostic intestinal biopsy in some settings. On the other hand, as predictors of intestinal damage and for use in monitoring disease activity, currently available noninvasive tests have been disappointing. Serologic tests, while a measure of disease activity, do not correlate well with histology or symptomatology, and it is unclear if they predict long-term risk. Additionally, while the many clinically available tests have improved accessibility, they can have widely different cutoff levels and overall performance, making the comparison of levels in individual patients over time and across populations quite difficult. In the future, we can expect to see improvement in the currently available serologic tests including tissue transglutaminase and deamidated gliadin peptide with expansion of the dynamic range of the tests, and the celiac care community should push for a standardization of assays that would simplify research and patient care. Additionally, current serologic tests are measures of the adaptive immune response in celiac disease but do not directly measure intestinal inflammation. Promising work on intestinal fatty acid-binding protein and other assays which directly measure intestinal damage may complement traditional serologic tests and further improve our ability to noninvasively diagnose and monitor celiac disease. The coming years hold promise for the continuing evolution of serum-based tests in celiac disease with the possibility of substantial improvement of patient care and clinical research.

scholarly journals Strongly Positive Tissue Transglutaminase Antibody Assays without Celiac Disease

2004 ◽  
Vol 18 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Hugh James Freeman
Keyword(s):  
Celiac Disease ◽  
Clinical Practice ◽  
Small Bowel ◽  
Tissue Transglutaminase ◽  
Yukon Territory ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Gluten Free ◽  
Test Kit ◽  
Small Intestinal

Celiac disease is a small bowel disorder characterized by flattened villi and crypt hyperplasia, often with malabsorption. Improvement occurs with a gluten-free diet. Sensitive and specific assays (eg, immunoglobulin A antibodies to tissue transglutaminase [tTG]) that can be quantified appear to be valuable tools for population screening studies. In addition, their use is expanding widely in the clinical practice arena, being employed as a method of case finding. In this evaluation, clinical use of a commercially available test kit was explored. Of 1330 samples submitted to our hospital laboratory by physicians in British Columbia, Alberta and the Yukon Territory (from 1999 to 2003, inclusive), 96 patients (7%) had increased values (normal range greater than 20 units) and markedly increased levels greater than 100 units were detected in 36 patients (3%). Of these, 14 patients (almost 40%) were referred to gastroenterologists in our hospital and all 14 had small intestinal biopsies. Of these, three patients (more than 20%) did not have celiac disease. Two had normal small bowel biopsies and one had unclassified sprue or 'sprue-like' intestinal disease that failed to respond to a gluten-free diet. The other 11 had biopsy-defined celiac disease. While the tTG assay may be a useful predictor of celiac disease, small intestinal biopsy is still required to confirm the diagnosis. In clinical practice, even strongly positive tTG results are not specific in individual patients, do not necessarily correlate with the degree of severity of biopsy change and, as a result, are also unlikely to be useful for monitoring diet compliance.

scholarly journals Serological Characterisation of Auto-antibodies in Patients with Direct Antiglobulin Test Positive Autoimmune Haemolytic Anaemia at a Tertiary Care Teaching Hospital in Tirupati, India

2021 ◽  
Author(s):  
Chinthapeta Keerthi ◽  
Rajendran Arun ◽  
Bandi Suresh Babu ◽  
Kinnera Vijaya Sreedhar Babu ◽  
Alladi Mohan ◽  
...  
Keyword(s):  
Haemolytic Anaemia ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Direct Antiglobulin Test ◽  
P Value ◽  
Igg Antibody ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Antiglobulin Test ◽  
Study Population

Introduction: Haemolysis in Autoimmune Haemolytic Anaemia (AIHA) is a result of Immunoglobulin G (IgG) or Immunoglobulin M (IgM) auto-antibodies with or without complement components binding to the Red Blood Cell (RBC) surface and initiating its destruction. Serologic evidence is provided by autocontrol or Direct Antiglobulin Test (DAT). Diagnostic work-up is essential as the management depends on the antibody type. Characteristics of the bound antibody and the target antigen determine the degree of haemolysis. Serological characterisation in AIHA helps to differentiate into its various types which help the clinician to decide on the treatment to be given. Aim: To serologically characterise the auto-antibodies in patients with DAT positive AIHA at a tertiary care teaching hospital. Materials and Methods: This cross-sectional study was carried out in the Department of Transfusion Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India, from March 2019 to February 2020. A 40 consecutive patient samples were included in the study. Characterisation of antibody was done using polyspecific Anti-Human Globulin (AHG) reagent followed by mono-specific AHG reagent by gel method. If antibody was of IgG type, then the subclass was determined by a mono specific anti-IgG1 and anti-IgG3 gel card. Association between antibody types, subtype, and strength of DAT with severity of haemolysis were compared using Chi-square/Fisher’s-exact test. A p-value of less than 0.05 was considered statistically significant. Results: The total study population was 40 patients. The mean age of the study population was 45 years (range 13-78). Out of 40 patients, males were 30 (75%) and females were 10 (25%). The primary and secondary causes for AIHA include 4 (10%) and 36 (90%) respectively. Among 40 patients, 22 (55%) patients had IgG antibody alone, 17 (42.5%) patients had IgG antibody with combination of other antibodies and 1 (2.5%) had only complement (C3d). IgG1 was identified in 7 (18%) of patients, combination of IgG1 and IgG3 in 3 (7.7%). There was a significant association with IgG+combination (p-value=0.03), IgG1+IgG3 (p-value=0.029) and strength of reaction (p-value=0.003) with respect to severity of haemolysis. Conclusion: Presence of multiple antibodies, presence of IgG1 and IgG3 and with complement combination and presence of higher grading of reaction in gel column were associated with severity of haemolysis. We recommend that serological characterisation of auto-antibody in AIHA would help the clinician in assessing the severity of haemolysis so that management can be done appropriately.

scholarly journals Pediatric Inflammatory Bowel Disease Associated With Celiac Disease: A Retrospective Study in a Tertiary Care Hospital in Saudi Arabia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110529
Author(s):  
Mamdouh Qadi ◽  
Mohammed Hasosah ◽  
Anas Alamoudi ◽  
Abdullah AlMansour ◽  
Mohammed Alghamdi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Saudi Arabia ◽  
Celiac Disease ◽  
Retrospective Study ◽  
Bowel Disease ◽  
National Guard ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Inflammatory Bowel

Background. Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic relapsing disease indicated by inflammation of the gastrointestinal tract. Celiac disease (CeD) is a chronic autoimmune disease of the small bowel. The prevalence of CeD in IBD patients is unknown. Some studies have described the coexistence of the 2 diseases in the same patient. This study aimed to investigate the prevalence of CeD in Saudi Arabian children with IBD. Methods. We used a retrospective study design because data can be collected immediately and is easier to analyze afterward. The study was conducted on IBD patients in the Pediatric Gastroenterology Department at National Guard Hospital, Jeddah, Saudi Arabia. We enrolled Saudi patients aged between 1 and 18 years who had been diagnosed with IBD and CeD based on positive biochemical serology and histology from January 2011 to January 2020. We excluded patients with immunodeficiency disorders. Results. Among the 46 enrolled patients with IBD, CeD was identified in 4, and they did not develop any relapses. We discovered that the weight at IBD diagnosis improved significantly compared to current weight ( P-value < .0001). We also discovered that the height at diagnosis of IBD improved significantly compared to the current height ( P-value < .0001). Additionally, we found no significant associations between UC and CeD ( P-value = 1), or CD and CeD ( P-value = .625). Conclusion. No significant associations were evident between the prevalence of CeD and IBD. More prospective multicenter studies are needed to clarify the prevalence of CeD in children with IBD.

Effects of breast milk on pain severity during muscular injection of hepatitis B vaccine in neonates in a teaching hospital in Iran

2018 ◽  
Vol 25 (6) ◽  
pp. 365-370 ◽  
Author(s):  
Z. Hatami Bavarsad ◽  
K. Hemati ◽  
K. Sayehmiri ◽  
P. Asadollahi ◽  
G. Abangah ◽  
...  
Keyword(s):  
Breast Milk ◽  
Hepatitis B ◽  
Teaching Hospital ◽  
Hepatitis B Vaccine ◽  
Pain Severity
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