Investigation of celiac disease according to Marsh classification in childhood

Bekdaş, Mervan; Ünal, Fatih; Demircioğlu, Fatih

doi:10.3329/bjms.v16i2.26700

Cited by 4 publications

(4 citation statements)

References 24 publications

(31 reference statements)

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“…This is in accordance with multiples studies which showed gastrointestinal symptoms are more common in patients with high grade small intestinal mucosahistopathology. 15 In our population, mean serum TTGIgA and TTGIgG antibodies titers were documented to be higher in patients with CCD in comparison to NDCD. TTG IgA seropositivity is linked with more intense disease.…”

Section: Discussionmentioning

confidence: 53%

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Spectrum of Celiac disease in Paediatric population: Experience of Tertiary Care Center from Pakistan

et al. 2017

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Objective:To determine clinical features and relevant laboratory investigations of patient with celiac disease (CD) and comparing classical celiac disease (CCD) with Non-diarrheal celiac disease (NDCD).Methods:This is a five years retrospective study conducted at The Aga Khan University Hospital Karachi, Pakistan from January 2010 to December 2015, enrolling children from one year to 15 years of either gender diagnosed as celiac disease in accordance with revised ESPGHAN criteria. Biopsy samples with grade 2 or more on Modified Marsh Classification were considered as consistent with celiac disease. Celiac patients were categorized into Classical celiac disease (with Chronic Diarrhea) and non-diarrheal celiac disease (Atypical celiac) and their clinical features and relevant laboratory investigations were documented.Results:Total 66 patients were selected with celiac disease according to inclusion criteria, 39 (59.09%) patients were labeled as CCD and 27 (40.91%) patients were labeled as NDCD. Marsh grading 3a and above were more marked in CCD as compared to NDCD. Mean titer for Tissue transglutaminase antibodies (TTG) were higher in CCD group in comparison to NDCD group. In CCD, the most common clinical presentations were abdominal distension whereas in NDCD, the most remarkable features were recurrent abdominal pain (62.9%). Frequency of failure to thrive is significantly high in CCD (82.05%) but patients merely with short stature were more common in NDCD (33.3%). Refractory anemia was present in 66.6% patients in NDCD group and 41.1% patients in CCD group. 74.3% patients in CCD group were vitamin D deficient whereas 85% patient had vitamin D deficiency in NDCD group (p= 0.03).Conclusion:NDCD is not uncommon in our population. Recurrent abdominal pain, failure to thrive or patients only with short stature and refractory anemia are prominent features in NCDC group whereas abdominal distension, failure to thrive and recurrent abdominal pain were noticeable features in CCD. High grade histopathology and raised antibodies titer is hallmark of CCD. Vitamin D deficiency is almost equally present in both groups.

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Section: Discussionmentioning

confidence: 53%

“…TTG IgA seropositivity is linked with more intense disease. 15 Bhattacharya M et al established significant correlation between TTG IgA antibodies titers and higher grades of small intestinal histopathology. 16 …”

Section: Discussionmentioning

confidence: 99%

Spectrum of Celiac disease in Paediatric population: Experience of Tertiary Care Center from Pakistan

et al. 2017

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“…The reason behind the increased frequency of Marsh III A might be related to an early diagnosis of the studied samples. Comparable frequencies have also been presented; 5.3% Marsh III C, 24.2%, 55.3% Marsh III-A, and 15.1% Marsh III B and Marsh III C[24]. In this study, serum concentrations of anti-tTG and anti-gliadin IgA antibodies were significantly elevated in CD children compared to healthy children (73.8 and 31.8 vs.…”

supporting

confidence: 60%

Gene Expression of NLRP3 Inflammasome in Celiac Disease of Iraqi Children

Al-Assaf¹,

Ali²,

Ad’hiah³

2021

IHJPAS

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Celiac disease (CD) is an autoimmune disorder characterized by chronic inflammation that essentially affects the small intestine and is caused by eating gluten-containing foods. This study sought to determine gene expression of NLRP3 Inflammasome in peripheral blood of Iraqi CD children using quantitative real-time PCR (qRT-PCR) assay. Thirty children with CD (12 males and 18 females) were enrolled in the study and their age range was 3-15 years. The diagnosis of the disease was confirmed by serological examinations and intestinal endoscopy. A control sample of 20 age-matched healthy children was also included. The children were stratified for age, gender, body max index (BMI), histological findings, and marsh classification. Further, the sera were examined for IgA anti-tissue transglutaminase (tTG) antibody, IgA anti-gliadin antibody, and interleukin-1 beta (IL-1Î²). Based on Marsh classification, the results revealed that the majority of patients (70%) had partial villous atrophy (Marsh Ð¨ 3A), while children with subtotal and total villous atrophy (Marsh III: 3B/3C) were presented with a lower frequency (30.0%). Neither Marsh I nor Marsh II has been observed among the patients studied. Serum levels of anti-tTG and anti-gliadin IgA antibodies were significantly higher in CD children than in control children (73.8 and 31.8 vs. 0.8 U//ml, respectively; p < 0.001). Conversely, IL-1Î² serum level was decreased in CD children but the difference was not significant (35.5vs. 53.4 pg/ml; p = 0.285). In the case of NLRP3 inflammasome, the Relative Fold Change method (2-âˆ†âˆ†Ct) was used to assess the gene expression. The results revealed that the expression of NLRP3 inflammasome was decreased by 0.594 fold in CD children. In conclusion, the NLRP3 inflammasome was down-regulated in the present sample of CD children, and it was accompanied by a decreased serum level of IL-1Î².

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“…The significant features of the disease are malabsorption and villous atrophy that occur in the intestinal system when a person ingests food which contains gluten. 1 To obtain a confirmed identification of celiac disease, a biopsy of the small intestine is often documented to be the preferred method of diagnosis. Celiac disease has been noted to have a varied presentation.…”

Section: Introductionmentioning

confidence: 99%

Celiac Disease Investigation with Marsh Classification in Paediatric Population

Ghafoor

Ikram

Zaman

et al. 2022

PAFMJ

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Objective: To determine the celiac disease using Marsh classification in the paediatric population at the Pak Emirates Military Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Paediatrics, Pak Emirates Military Hospital Rawalpindi Pakistan, from Aug 2020 till Mar 2021. Methodology: Patients of either gender aged 1 to 14 years with three or more clinical features of celiac disease such as chronic diarrhoea, any degree of malnutrition, short stature, abdominal distension, anaemia, and clubbing at the time of admission, were included in this study. Results: There were 97 patients in this study. Among them, 61 (62.9%) were males, and 36 (37.1%) were females. There were 56 (57.7%) patients who were histology positive and 41 (42.3%) patients who were histology negative. There were 37 (38.1%) patients in Marsh III a, 15 (15.5%) were in Marsh III b, and 4 (4.1%) patients were in the Marsh III c category. Gender distribution showed that 33 (58.9%) males were positive compared to 23 (41.1%) females. Even though the frequency was higher among males, the difference was not statistically significant (p-value=0.23). Conclusion: Celiac disease is a possible reason for anaemia among patients with iron deficiency anaemia of unknown origin. Therefore, the histopathological diagnosis should be completed when celiac disease is suspected.

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Investigation of celiac disease according to Marsh classification in childhood

Cited by 4 publications

References 24 publications

Spectrum of Celiac disease in Paediatric population: Experience of Tertiary Care Center from Pakistan

Spectrum of Celiac disease in Paediatric population: Experience of Tertiary Care Center from Pakistan

Gene Expression of NLRP3 Inflammasome in Celiac Disease of Iraqi Children

Celiac Disease Investigation with Marsh Classification in Paediatric Population

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