scholarly journals Celiac Disease and Non-celiac Gluten Sensitivity Screening in Juvenile Idiopathic Arthritis Patients

2020 ◽  
Author(s):  
Günsel Kutluk ◽  
Hafize Emine Sönmez ◽  
Hülya Kaçmaz
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Cross Sectional Study ◽  
Gluten Sensitivity ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
The Mean ◽  
Autoimmune Etiology ◽  
Endomysium Antibody

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.

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
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Cross Sectional Study ◽  
Depressive Illness ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Psychosocial Impairment ◽  
Asking Questions ◽  
Male Patients ◽  
Disease Study

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.

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 The Prevalence of Celiac Disease-Specific Auto-Antibodies in Type 1 Diabetes in a Moroccan Population

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Ider Oujamaa ◽  
Majda Sebbani ◽  
Lahcen Elmoumou ◽  
Aïcha Bourrahouate ◽  
Rabiy El Qadiry ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Iga Deficiency ◽  
Cross Sectional Study ◽  
Biological Data ◽  
Cross Sectional ◽  
Systematic Screening ◽  
Lower Height ◽  
Hla Dq2

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.

scholarly journals Fibrinogen status in relapse and remission of childhood nephrotic syndrome

2016 ◽  
Vol 46 (4) ◽  
pp. 149
Author(s):  
Veronica Lily Limantara ◽  
Ida Bagus Mudita ◽  
I Ketut Suarta
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Albumin ◽  
Cross Sectional Study ◽  
Fibrinogen Concentration ◽  
Strongly Correlated ◽  
Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Remission Status ◽  
The Mean

Objective To evaluate fibrinogen concentration of relapsing neph-rotic syndrome (NS) in children, and to investigate relationshipbetween fibrinogen with albumin and cholesterol.Methods A cross-sectional study among NS patients admitted topediatric outpatient clinic and pediatric ward at Sanglah Hospital,Denpasar, from November 1, 2003 to January 31, 2004. All pa-tients were evaluated for clinical and laboratory findings of relapseand remission, including edema, proteinuria, serum albumin, totalcholesterol, as well as total platelet count and fibrinogen concen-tration to evaluate coagulation parameters in nephrotic patients.Results There were 36 patients with the mean age of 7.4 (SD 2.3)years included in this study. Mean fibrinogen concentration in re-lapse state was 671.8 (SD 102.7) mg/dl, while in remission statewas 255.2 (SD 50.5 mg/dl); the mean difference was 416.6 mg/dl(95% CI 362.9;470.4; P<0.001). Fibrinogen was inversely andstrongly correlated with serum albumin concentrations (r=-0.91;P<0.001). Fibrinogen was positively and strongly correlated to to-tal cholesterol (r=0.80; P<0.001). Using multiple regression analy-sis, it was shown that only relapse/remission status was signifi-cantly associated with fibrinogen concentration (P<0.001).Conclusion Fibrinogen status is significantly correlated with re-lapse and remission status of NS in childhood patients.

scholarly journals Prevalence Of Irritable Bowel Syndrome, Celiac Disease And Their Manifestations Among Muhimbili University Of Health And Allied Sciences Staff And Students: A Cross Sectional Study

2020 ◽  
Author(s):  
Adam Miraj Gembe
Keyword(s):  
Health Care ◽  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Medical Students ◽  
Health Care Professionals ◽  
Tissue Transglutaminase ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Irritable Bowel

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.

scholarly journals Short stature as a significant marker in celiac disease

2019 ◽  
Vol 6 (5) ◽  
pp. 1855
Author(s):  
Jasraj Bohra ◽  
Virendra K. Gupta ◽  
Ashok Gupta
Keyword(s):  
Celiac Disease ◽  
Short Stature ◽  
Tissue Transglutaminase ◽  
Gastrointestinal Symptoms ◽  
Cross Sectional Study ◽  
Anthropometric Measurement ◽  
Clinical Feature ◽  
Serum Samples ◽  
Cross Sectional ◽  
The Difference

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.

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 Echocardiographic and Laboratory Findings in Coronary Slow Flow Phenomenon: cross-sectional study and review

2020 ◽  
Author(s):  
Mir Hosein Seyyed Mohammadzad ◽  
Salar Gardeshkhah ◽  
Kamal Khademvatani ◽  
Amin Sedokani
Keyword(s):  
Coronary Arteries ◽  
Cross Sectional Study ◽  
Control Group ◽  
Slow Flow ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Coronary Slow Flow ◽  
Flow Group ◽  
The Mean ◽  
Coronary Slow Flow Phenomenon

AbstractBackground and aimsCoronary Slow flow is a phenomenon known as slow contrast flow that injected into the coronary arteries, without epicardial coronary arteries obstruction. The etiology of this disease is unknown. Endothelial dysfunction, known as a major cause of Coronary Slow flow syndrome (CSF).MethodsThis study was cross-sectional (descriptive-analytic), which was performed on patients admitted to Seyedoshohada Heart Center, during one year (2018-2019). Considering the inclusion and exclusion criteria, patients were divided into two groups of normal coronary arteries (NECA, as the control group) and with the Coronary slow-flow (CSF).ResultsIn the present study, 124 patients were studied, 67.9% in the coronary slow flow group and 39.4% in the control group were men (p=0.001). In the coronary slow flow group, the mean age of patients was 52.18 ± 12.55 years and in the control group, the mean age was 51.77 ± 10.36 years (p=0.18). Mean BMI was significantly higher in the coronary slow flow group than the control group (p <0.05). The smoking, hypertension, and mean of Lymphocyte, Hb, Hct, Plt, MPV, RDW, BUN, FBS, TG, TC, LDL was significantly higher coronary slow flow group. Also, in echocardiography, the mean E wave, E/A ratio was significantly lower in the coronary slow flow group. The GLS was also significantly lower in the control group (p=0.01). LAD was the most common type of coronaries that involved with a slow flow.ConclusionThe results of this study showed that there was a significant increase in the rate of coronary slow flow in men, smokers, high BMI, and hypertensive patients. Also, platelet count, MPV, LDL, FBS, and some laboratory variables were high in patients with CSF. Mild diastolic dysfunction and low GLS were observed in this group of patients.

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.

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