Coeliac disease in children

Thomas, P.C.; Tighe, Mark; Beattie, R Mark

doi:10.1136/bmj.k3932

Cited by 10 publications

(9 citation statements)

References 21 publications

(35 reference statements)

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“…However, patients in the 14‐35‐year‐old group showed a relatively higher prevalence rate. This may be related to older patients with coeliac disease having milder/asymptomatic disease, while younger patients show more symptomatic disease 38,41,42 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Zhou

Gao

et al. 2020

Aliment Pharmacol Ther

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Background: Epidemiological data of coeliac disease are lacking from the central Asian region. Aims: To verify the occurrence of coeliac disease amongst four major ethnic groups of Xinjiang Uyghur Autonomus Region, China. Methods: 2277 in-patients with gastrointestinal symptoms (1391 Han, 608 Uyghur, 146 Kazakh and 132 Hui; mean age: 54 ± 12.8 years) were included. Total IgA, antideamidated gliadin peptide (DGP)-IgG, and anti-tissue transglutaminase (anti-tTG)-IgA were analysed. All antibody-positive subjects were further tested for endomysial (EMA) antibodies and were HLA genotyped. All subjects with antibody positivity were asked to undergo intestinal biopsy. In addition, a subset of antibody-negative subjects were tested for HLA-DQA1and DQB1.Results: Among the 2277 subjects, 29 subjects were defined as coeliac disease autoimmune (positive results for anti-tTG IgA and EMA-IgA) (1.27%; 95% confidence interval, 0.81%-1.73%), eight of them underwent biopsy and all showed coeliac disease histology (0.35%; 95% Cl, 0.11%-0.59%). The frequency of coeliac disease autoimmunity was lowest among the Han (0.79%), followed by the Uyghur (1.81%), the Kazakh (2.05%) and the Hui (3.03%). The frequency of the HLA-DQ2 and/or DQ8 haplotype was highest in the Uyghur (52.1%), followed by the Hui (44.4%), the Kazakh (40.0%) and the Han (39.4%). Besides, a three times higher frequency of coeliac disease autoimmunity was found among rural living subjects with significantly higher wheat consumption compared to urban living subjects (3.16% vs 0.97%, P < 0.01). Conclusions:In Xinjiang, coeliac disease does occur, especially in the rural area. The HLA haplotype and environment play key roles in the development of coeliac disease. | 1117ZHOU et al.

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Section: Discussionmentioning

confidence: 99%

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Zhou

Gao

et al. 2020

Aliment Pharmacol Ther

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“…A marginally elevated TTG antibody level has a relatively weak positive predictive value (approximately 33%) for histologically confirmed coeliac disease, reflecting the 1.4% population prevalence 79. In contrast, very high values of TTG antibody (>10× upper limit of normal) are extremely likely to be associated with a histological diagnosis of coeliac disease 12. As with serological testing, histology is only interpretable if the patient has been on a gluten-containing diet for four weeks before the time of biopsy, and patients should be advised to continue a normal diet while awaiting endoscopy 7.…”

Section: What Is the Role Of Upper Gastrointestinal Endoscopy And Duomentioning

confidence: 99%

Investigating coeliac disease in adults

Ashton

Smith

et al. 2020

BMJ

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“…Para la toma de muestras de serologías y biopsias, se debe recomendar a los pacientes o a sus padres y cuidadores que se siga una dieta con gluten, la cual varía según la literatura. Se menciona en algunos casos 3-7,5 g/d por 2 semanas (1), en otras un mínimo de 10 g de gluten diarios, por al menos 6 semanas previo a la toma de estas muestras (15). Las serologías de los pacientes con dietas libres de gluten pueden normalizarse con pocos meses desde el inicio, o hasta un año después (14).…”

Section: Abordaje Diagnósticounclassified

“…Los exámenes genéticos es mejor que sean realizados por un gastroenterólogo pediatra, no desde un nivel primario. El abordaje sin la biopsia se puede realizar tanto en pacientes sintomáticos como en asintomáticos, y se resume en la tabla 2 (1,15,16). Es importante que, en niños pequeños, los anticuerpos anti-péptido deaminado de gliadina pueden estar positivos de forma transitoria, por lo que realizar este examen adicional no le agrega especificidad al diagnóstico (1).…”

Section: Pruebas Serológicasunclassified

Abordaje de la enfermedad celiaca en pediatría

2022

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La enfermedad celiaca es una patología sistémica autoinmune, en la cual la ingesta de gluten en personas con susceptibilidad genética se desencadena una respuesta inmune, causando manifestaciones clínicas no solo a nivel gastrointestinal, sino también sistémico. Su prevalencia e incidencia han ido en aumento y es un importante diagnóstico en la población pediátrica. Debido a que la enteropatía llevará a problemas como malabsorción, pérdida de peso y deficiencias nutricionales, se debe tamizar a los grupos de riesgo y también a los niños con clínica compatible con la enfermedad, para evitar grandes consecuencias en su desarrollo, y mayores complicaciones. El diagnóstico se basa en la sospecha clínica, el uso de serologías, y en algunos casos, la toma de biopsias y/o las pruebas genéticas. Una dieta libre de gluten es la medida más importante para lograr la resolución de los síntomas y la normalización de la arquitectura intestinal.

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Coeliac disease in children

Cited by 10 publications

References 21 publications

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Investigating coeliac disease in adults

Abordaje de la enfermedad celiaca en pediatría

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