Coeliac disease among children in Kuwait: difficulties in diagnosis and management.

Khuffash, Faisal A.; Barakat, M.H.; Shaltout, Azza; Farwana, S; Adnani, M. S. Al; Tungekar, M. F.

doi:10.1136/gut.28.12.1595

Cited by 26 publications

(21 citation statements)

References 14 publications

(2 reference statements)

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“…Studies from Sweden, Holland and Italy showed up to two‐fold differences in CD incidence or prevalence in different regions or cities, attributed to varying disease awareness, healthcare behaviour and dietary gluten intake, possibly influenced by socio‐economic factors. In a defined area in Kuwait, CD was three times more common among Palestinians, whose staple diet was wheat, compared with Kuwaities who consumed rice . In Israel, CD is commoner among Jews compared with Arabs, possibly due to different levels of clinical suspicion in the two communities…”

Section: Resultsmentioning

confidence: 99%

“…Significant inter-country differences are apparent. Considering various time periods together, incidence rates for both sexes combined ranged from 0.9 to 12.9/ 100 000/year for all ages combined, 20-26 0-3.7/1000 live births for children [15][16][17][18][19][20][21]24,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] and 1.27-39/100 000/year for adults. 35,[45][46][47] Again considering various time periods together, prevalence rates for both sexes ranged from 8.1 to 204/100 000 for all ages, 26, 48-51 4.7-250/100 000 for children 16,19,26,48,52,53 and 45.9-550/100 000 for adults.…”

Section: Incidence and Prevalence Of Clinically Diagnosed CD (Tables mentioning

confidence: 99%

“…In a defined area in Kuwait, CD was three times more common among Palestinians, whose staple diet was wheat, compared with Kuwaities who consumed rice. 37 In Israel, CD is commoner among Jews compared with Arabs, possibly due to different levels of clinical suspicion in the two communities. 224 The incidence of clinically diagnosed childhood CD in a German community in Italy was three times that in their Italian counterparts.…”

Section: Comparison Between Countries and Regionsmentioning

confidence: 99%

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Systematic review: worldwide variation in the frequency of coeliac disease and changes over time

Kang

Green

et al. 2013

Aliment Pharmacol Ther

230

182

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Summary Background Coeliac disease (CD), originally thought to be largely confined to Northern Europe and Australasia and uncommon in North America and the Middle East, is now recognised to be equally common in all these countries. It is still thought to be rare in the Orient and Sub‐Saharan Africa. Aim To assess geographical differences and time trends in the frequency of CD. Methods Medline and Embase searches were conducted on 10 November 2012, from 1946 and 1980 respectively, using the key words: coeliac disease or celiac disease + prevalence or incidence or frequency. Results There were significant intra‐ and inter‐country differences in the prevalence and incidence of CD. Only 24 ethnic Chinese and Japanese patients have been reported in the English literature. Of CD‐associated HLA DQ antigens, DQ2 occurs in 5–10% of Chinese and sub‐Saharan Africans, compared to 5–20% in Western Europe. DQ8 occurs in 5–10% of English, Tunisians and Iranians, but in <5% of Eastern Europeans, Americans and Asians. The prevalence and incidence of both clinically and serologically diagnosed CD increased in recent years. These geographical and temporal differences seem genuine, although variable indices of suspicion and availability of diagnostic facilities are confounding factors. Conclusions Coeliac disease is increasing in frequency, with significant geographical differences. Although few cases have been described to date in the Orient and Sub‐Saharan Africa, there is a significant prevalence of HLA DQ2 and wheat consumption is of the same order as that in Western Europe. CD may therefore become more common in the future in these countries.

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Section: Resultsmentioning

confidence: 99%

Section: Incidence and Prevalence Of Clinically Diagnosed CD (Tables mentioning

confidence: 99%

Section: Comparison Between Countries and Regionsmentioning

confidence: 99%

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Systematic review: worldwide variation in the frequency of coeliac disease and changes over time

Kang

Green

et al. 2013

Aliment Pharmacol Ther

230

182

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“…There are only few studies addressing the prevalence of the disease in a healthy population in the Middle East [14], and epidemiological studies of the disease in Iran are not available. Our study is the first screening study for coeliac disease among a selected predominantly male population in Iran.…”

Section: Discussionmentioning

confidence: 97%

High prevalence of coeliac disease in apparently healthy Iranian blood donors

Shahbazkhani

Malekzadeh

Sotoudeh

et al. 2003

European Journal of Gastroenterology & Hepatology

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“…The prevalence of celiac disease in Tunisian schoolchildren, estimated to be about 1/157 which is close to the European prevalence (2) . In Jordan the serological prevalence was estimated to be 1:124 in schoolchildren (4) , whereas the average annual incidence in Kuwait is 1:3000 (5) . To date no prevalence of celiac disease data were reported from Iraq.…”

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confidence: 99%

Value of clinical data in diagnosis of symptomatic celiac disease in children

Hafidh¹

2012

Ann Coll Med Mosul

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Objective:To identify the value of clinical data in diagnosis of celiac disease (CD) in children. Patients and methods: a prospective study was conducted in Mosul city during the period from 30 th of October 2007 to 30 th of April 2011. A total of 57 patients (39 males, 18 females) aged more than 6 months on gluten containing diet presented with symptoms suggestive of (CD) were evaluated clinically and serologically using IgA human recombinant tissue transglutaminase antibody. (IgA anti tTG2). Multiple duodenal biopsies were performed for every patient enrolled in this study. CD cases had been followed up 6 months after a gluten free diet (GFD) by weight measurement and the mentioned serological testing. Results: A total of 29 (50.9%) out of 57 symptomatic patients with mean age of 56.1 months, demonstrated positive biopsy results for celiac disease. Failure to thrive (FTT) was noticeable in 25 (86.2%) of studied patients with celiac disease followed by anemia, abdominal distension, offensive stool and chronic diarrhea in decreasing frequency. Catch up of weight was not achieved in 10 (43.5%) out of 23 CD patients with FTT whose (IgA anti tTG2) normalized after 6 months of GFD. Conclusions:The diagnosis of celiac disease on the basis of clinical features alone was incorrect in (49.1%) cases, indicating that diagnosis and lifelong GFD treatment is not justifiable relying on clinical data. Catch up of weight cannot be relied upon as an early marker of clinical improvement in patients with proven adherence to GFD. The result of this study emphasizes the importance of increasing awareness of the accurate tools in diagnosis of CD in children based on serological and biopsy evidences.

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Coeliac disease among children in Kuwait: difficulties in diagnosis and management.

Cited by 26 publications

References 14 publications

Systematic review: worldwide variation in the frequency of coeliac disease and changes over time

Systematic review: worldwide variation in the frequency of coeliac disease and changes over time

High prevalence of coeliac disease in apparently healthy Iranian blood donors

Value of clinical data in diagnosis of symptomatic celiac disease in children

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