Coeliac disease as a cause of osteomalacia and rickets in the Asian immigrant population.

Thalayasingam, B

doi:10.1136/bmj.290.6475.1146-c

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…Coeliac disease accounted for 2.5% of Asian cases in this study and should not be forgotten as a cause of osteomalacia in this group. 15,16 In summary, for populations with a high prevalence of vitamin D deficiency or osteomalacia, biochemical assessment of suspected cases should include measurement of PTH, Ca, creatinine, FBC and endomysial antibodies. If only routine biochemistry is used, a substantial minority of these high-risk cases will be missed.…”

Section: J O U R N a L O F T H E R O Y A L S O C I E T Y O F M E D I mentioning

confidence: 99%

Routine Biochemistry in Suspected Vitamin D Deficiency

Peacey

2004

J R Soc Med

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Vitamin D deficiency, which continues to be widespread amongst persons of Asian descent in the UK, is often detected from abnormal results on routine biochemistry. The aim of this study was to assess the frequency of abnormal results from routine baseline tests of serum calcium, phosphate, and alkaline phosphatase in patients who subsequently proved to have vitamin D deficiency and secondary hyperparathyroidism. A retrospective examination was undertaken to assess these baseline indices in a cohort of 84 such patients seen in Bradford-5 male; 80 of Asian descent; median age 46 years (range 16-82); serum 25-hydroxyvitamin D<10 microg/L; parathyroid hormone >54 ng/L. Calcium was normal in 55 patients (66%), phosphate in 68 (81%) and alkaline phosphatase in 24 (29%). In only 5 patients were all three indices outside the normal range. The median parathyroid hormone concentration was significantly greater in patients with abnormal routine biochemistry (145 [range 55-1662] ng/L) than in patients with normal routine biochemistry (88 [59-322] ng/L) but the median 25-hydroxyvitamin D levels did not differ (3.1 [1.3-9.9] and 3.0 [1.5-7.3] microg/L). Routine biochemistry was normal in 20% of cases. If routine biochemistry is relied upon to detect vitamin D deficiency and osteomalacia, a substantial minority of cases will be missed.

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Section: J O U R N a L O F T H E R O Y A L S O C I E T Y O F M E D I mentioning

confidence: 99%

Routine Biochemistry in Suspected Vitamin D Deficiency

Peacey

2004

J R Soc Med

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“…However, CD can be asymptomatic. 10 , 11 The objective of this study was to examine the prevalence of celiac disease presenting as rickets in Saudi children at a tertiary hospital setting.…”

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confidence: 99%

Celiac disease presenting as rickets in Saudi children

Assiri

Saeed

et al. 2013

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVESRickets is commonly seen as a sign of malabsorption like celiac disease if it is not treated appropriately with vitamin D and calcium supplements. The aim of this study was to examine the frequency of diagnosis of celiac disease among children with unexplained rickets in Saudi children at a tertiary hospital setting.DESIGN AND SETTINGRetrospective review of records of patients referred over 10 years to a pediatric gastroenterology and hepatology unit.PATIENTS AND METHODSThe study included all patients referred for evaluation of unexplained rickets and osteomalacia and screened for celiac disease. The diagnosis of rickets was made on the basis of history, physical examination, biochemical and radiological investigations. The diagnosis of celiac disease was made based on the ESPGHAN (European Society for Pediatric Gastroenterology, Hepatology, and Nutrition) criteria.RESULTSTwenty-six children with a mean (SD) age of 9.5 (4.6) years (5 males, range 1–15 years) were referred for evaluation of unexplained rickets and were screened for celiac disease. The diagnosis of celiac disease based on small bowel biopsy findings was confirmed in 10 (38.4%) patients with rickets. Serological markers for celiac disease including antiendomyseal antibodies and antitissue transglutaminase antibodies were positive in all ten children.CONCLUSIONRickets is not an uncommon presentation of celiac disease in Saudi children and pediatricians should consider celiac disease as an underlying cause for rickets.

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“…First description of CD in children of Asian descent immigrating to Western countries such as England [ 2 , 3 ] was later described in an Italian multicentre study as well [ 4 ]. Considering how these children share the same environment and dietary habits as Italian children, it could be appropriate to wonder about the role of gluten in the development of CD in Western countries.…”

Section: Discussionmentioning

confidence: 99%