Celiac Disease in Children with Severe Acute Malnutrition (SAM): A Hospital Based Study

Beniwal, Neetu; Ameta, Gaurav; Chahar, C. K.

doi:10.1007/s12098-017-2300-x

Cited by 16 publications

(12 citation statements)

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“…Results of T-tIgA findings in the present study of different age-group suggested that 76.1% of children showed T-tIgA level up to 10 au/ml(negative) and maximum positive for T-tIgA (17.9%) were >200 au/ml. One another study conducted in PBM Children Hospital, Bikaner from July 2012 through December 2013 by Beniwal N et al 11 All consecutively admitted children with SAM were recruited. All subjects were screened for Celiac disease by serological test for IgA-anti tissue Transglutaminase (IgA tTG) antibodies.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical profile of celiac disease among malnourished children in South Rajasthan, India

Sharma

Mandot

2018

Int J Contemp Pediatr

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Background: Celiac disease (CD) is the most common genetically related food intolerance, worldwide. The objective of this study was to study the prevalence and clinical profile of malnourished children. Methods: It was a prospective and observational study. The present study was conducted in the Department of Paediatrics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan. Two hundred and one children were studied. All malnourished children were initially selected and those fulfilling inclusion criteria were included in the study. A detailed interview of all the children/parents was conducted regarding symptoms commonly associated with celiac disease. All cases found positive for t-TGA (>10au/ml) were subjected to upper GI Endoscopy. Subjects were labelled as celiac disease if tissue trans-glutaminase IgA antibodies were >10 au/ml and histopathology was suggestive. Statistical analysis was done by one way ANOVA test and Chi-square as per requirements also Fisher exact and Man Whitney were applied. Results: Celiac disease was present in 23.9% of malnourished patients. Most common presenting symptoms were diarrhoea (40.2%), abdominal distension (39.9%) and abdominal pain (36.8%) and most common clinical sign was pallor, which was present in more than three-fourth of the patients (85.9%) followed by multivitamin deficiency (25.4%). Conclusions: There is a high prevalence of Celiac disease in malnourished children. Screening for Celiac disease (especially in presence of diarrhoea and abdominal distension, pain abdomen) should be an essential part of work-up in all malnourished children.

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Section: Discussionmentioning

confidence: 99%

Prevalence and clinical profile of celiac disease among malnourished children in South Rajasthan, India

Sharma

Mandot

2018

Int J Contemp Pediatr

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“…Celiac Disease sero-positivity was maximum in 4 years age groups, suggesting cumulative effect of gluten in ingested diet with the age. Microcytic hypochromic anemia was more common finding in seronegative cases (66.25%) than seropositive cases (50%), while normocytic normochromic more common in seropositive cases but the difference between two groups was Prevalence reported by Kumar P et al was 13.1% (seropositive and biopsy confirmed) among the SAM prevalence for Celiac Disease eported by Beniwal N et al was 15.38% while prevalence of biopsy confirmed Celiac disease was 14.42% among the SAM children [15]. We compared various parameters in Celiac Disease seronegative and positivity was more in males as pared to females.…”

Section: Figure-4: Pbf-type Of Anemia In Casesmentioning

confidence: 86%

“…Out of these seropositive cases 7 patients (23.33%) showed only gy and these patients may have underlying IgA deficiency and may be missed if Prevalence reported by Kumar P et al was 13.1% (sero positive and biopsy confirmed) among the SAM children [14]. Sero-prevalence for Celiac Disease reported by Beniwal N et al was 15.38% while prevalence of biopsy confirmed Celiac disease was 14.42% among the SAM children [15]. We compared various parameters in Celiac Disease seronegative and seropositive cases.…”

Section: Figure-4: Pbf-type Of Anemia In Casesmentioning

confidence: 99%

“…The mean age of starting gluten containing diet in seropositive cases was 8.35±2.15 months. Beniwal N et al [15] reported mean age of starting gluten containing diet in Celiac Disease children of 10.33±5.20 months.…”

Section: Figure-4: Pbf-type Of Anemia In Casesmentioning

confidence: 99%

“…The clinical features of Severe Acute Malnutrition (SAM) often overlap with the common manifestations of Celiac Disease such as recurrent diarrhea, failure to thrive, vomiting, abdominal distension, anemia and weight loss [14][15]. As per NFHS-4 (2015-16) Severe Acute Malnutrition afflicts nearly 7.5% of children below 60 months of age in India [16].…”

Section: Introductionmentioning

confidence: 99%

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Clinico-laboratory profile of Seropositive Celiac Diseases in Severe Acute Malnutrition

Meena

Khan

et al. 2019

Int J Pediatr Res

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Introduction: Celiac Disease shares clinical features with malnutrition and may be responsible for malnutrition. The objective of this study was to study clinico-laboratory profile of seropositive Celiac Diseases in Severe Acute Malnutrition. Material & Methods: The present study was a prospective, hospital based, observational study conducted at Malnutrition Treatment Centre (MTC) of tertiary care Pediatric hospital associated with government medical college of southern Rajasthan. The study was conducted over the period of one year from Dec. 2017 to Nov. 2018. Total 110 children with Severe Acute Malnutrition enrolled and screened for Celiac Disease on the basis of celiac serology (tTg-IgA/IgG). Clinico-laboratory findings of celiac seropositive and seronegative patients were recorded and analysed statistically. Results: Celiacsero-positivity was observed in 30 cases (27.28%). Out of these seropositive cases 14 cases (46.66%) were seropositive for both tTg-IgA and IgG, while 9 cases (30%) were positive for only tTg-IgA and rest 7 cases (23.33%) were positive for only tTg-IgG. Most of the seropositive patients (12, 40%) were in age group of 4-5 years of age group. In seropositive cases recurrent blood in stool (54.45%) and recurrent diarrhoea (52.94%) were common clinical features at the time of admission. S. Vit. B12 & Folic Acid were low in all the patients but more seropositive patients showed low levels of S. Folic acid (P value <0.05). Conclusions: Recurrent diarrhoea and blood in stool were common presenting feature on admission in celiac seropositive patients suffering from severe acute malnutrition. Vit. B12 and Folic acid deficiency were also observed as a common finding in seropositive patients.

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A Comprehensive Review of Celiac Disease/Gluten-Sensitive Enteropathies

McAllister

Williams

Clarke

2018

Clinic Rev Allerg Immunol

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Celiac disease is a complex immune-mediated gluten-sensitive enteropathy with protean clinical manifestations. It is manifest in genetically predisposed individuals who ingest gluten in varying amounts. In broad terms, it is thought to affect 1% of the population in the USA. More specifically, the prevalence increases drastically from 1:133 in patients not-at-risk, to 1:56 in symptomatic patients, to 1:39 in patients with a second-degree relative with the diagnosis, and to 1:22 in patients with a first-degree relative with the diagnosis. It may be associated with several immune-mediated phenomena, autoimmune diseases, and complicated by vitamin and other trace element deficiencies, bone disease, and malignancy. Our understanding of celiac disease has evolved rapidly over the past two decades. This has led to several lines of enquiry on the condition and potential treatment options. More recently, several entities including gluten intolerance, non-celiac gluten sensitivity, and seronegative celiac disease have been described. These conditions are distinct from allergies or intolerance to wheat or wheat products. There are challenges in defining some of these entities since a large number of patients self-report these conditions. The absence of confirmatory diagnostic tests poses an added dilemma in distinguishing these entities. The differences in spectrum of symptoms and highlights of the variability between the pediatric and adult populations have been studied in some detail. The role of screening for celiac disease is examined in both the general population and "at risk" populations. Diagnostic strategies including the best available serologic testing, utility of HLA haplotypes DQ2 and DQ8 which are seen in over 90% of patients with celiac disease as compared with approximately 40% of the general population, and endoscopic evaluation are also reviewed. Comprehensive nutritional management after diagnosis is key to sustained health in patients with celiac disease. Simple algorithms for care based on a comprehensive multidisciplinary approach are proposed. Refractory and non-responsive celiac diseases in the setting of a gluten-free diet are examined as are novel non-dietary therapies. Finally, the association of other disease states including psychiatric illness, infertility, lymphoproliferative malignancy, and mortality is explored with special attention paid to autoimmune and atopic disease.

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Celiac Disease in Children with Severe Acute Malnutrition (SAM): A Hospital Based Study

Abstract: There is a high prevalence of Celiac disease in SAM. Screening for Celiac disease (especially in presence of pain abdomen and abdominal distension) should be an essential part of work-up in all children with SAM.

Cited by 16 publications

References 16 publications

Prevalence and clinical profile of celiac disease among malnourished children in South Rajasthan, India

Prevalence and clinical profile of celiac disease among malnourished children in South Rajasthan, India

Clinico-laboratory profile of Seropositive Celiac Diseases in Severe Acute Malnutrition

A Comprehensive Review of Celiac Disease/Gluten-Sensitive Enteropathies

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