The Prevalence of Celiac Disease in Children With Arterial Ischemic Stroke

Balcı, Oya; Sezer, Taner

doi:10.1097/mph.0000000000000661

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…The pathogenesis of stroke in CD youth may involve vitamin B12 deficiency[ 68 ] and possibly hyperhomocysteinemia, which may be secondary to folic acid deficiency[ 69 ], cerebral arterial vasculopathy, and antiphospholipid syndrome, a secondary autoimmune disorder[ 70 - 72 ]. Children with recurrent acute ischemic stroke should be screened for CD[ 73 ]. Because CD is a potentially treatable cause of cerebral vasculopathy and stroke[ 74 ], serology-specifically anti TTG antibodies should be included in the evaluation for cryptogenic stroke in childhood, even in the absence of typical gastrointestinal symptoms[ 72 ].…”

Section: Publication Summary Statisticsmentioning

confidence: 99%

Cardiovascular involvement in celiac disease

et al. 2017

WJC

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Celiac disease (CD) is an autoimmune response to ingestion of gluten protein, which is found in wheat, rye, and barley grains, and results in both small intestinal manifestations, including villous atrophy, as well as systemic manifestations. The main treatment for the disease is a gluten-free diet (GFD), which typically results in the restoration of the small intestinal villi, and restoration of other affected organ systems, to their normal functioning. In an increasing number of recently published studies, there has been great interest in the occurrence of alterations in the cardiovascular system in untreated CD. Herein, published studies in which CD and cardiovascular terms appear in the title of the study were reviewed. The publications were categorized into one of several types: (1) articles (including cohort and case-control studies); (2) reviews and meta-analyses; (3) case studies (one to three patient reports); (4) letters; (5) editorials; and (6) abstracts (used when no full-length work had been published). The studies were subdivided as either heart or vascular studies, and were further characterized by the particular condition that was evident in conjunction with CD. Publication information was determined using the Google Scholar search tool. For each publication, its type and year of publication were tabulated. Salient information from each article was then compiled. It was determined that there has been a sharp increase in the number of CD - cardiovascular studies since 2000. Most of the publications are either of the type “article” or “case study”. The largest number of documents published concerned CD in conjunction with cardiomyopathy (33 studies), and there have also been substantial numbers of studies published on CD and thrombosis (27), cardiovascular risk (17), atherosclerosis (13), stroke (12), arterial function (11), and ischemic heart disease (11). Based on the published research, it can be concluded that many types of cardiovascular issues can occur in untreated CD patients, but that most tend to resolve on a GFD, often in conjunction with the healing of small intestinal villous atrophy. However, in some cases the alterations are irreversible, underscoring the need for CD screening and treatment when cardiovascular issues arise of unknown etiology.

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Section: Publication Summary Statisticsmentioning

confidence: 99%

Cardiovascular involvement in celiac disease

et al. 2017

WJC

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“…Studies with large populations exploring the association between CD and pediatric stroke show a low incidence of AIS in CD children [12,13]. One study found that 2 out of 76 (2.26%) pediatric AIS patients and 2 out of 102 (1.96%) healthy children had positive serum tissue transglutaminase antibodies; this difference was not statistically significant [12].…”

Section: Discussionmentioning

confidence: 99%

“…One nationwide cohort study conducted in Sweden demonstrated that the excess risk of stroke in patients with CD was 24/100,000. Conversely, other research indicates little to no risk of AIS in pediatric patients with CD [12,13]. Therefore, this study aims to examine the incidence and outcomes of pediatric AIS patients with CD in a large nationwide sample.…”

Section: Introductionmentioning

confidence: 97%

Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease

Vazquez

Thaker

Nolan

et al. 2023

Life

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(1) Background: Celiac disease (CD) can cause long-term inflammation and endothelial dysfunction and has been cited as a risk factor for acute ischemic stroke (AIS) in pediatric patients. However, the rate and outcomes of AIS in pediatric patients with CD has not been explored in a large population. Our objective is to explore the rate, severity, and outcomes of CD amongst pediatric AIS patients on a nationwide level. (2) Methods: The National Inpatient Sample (NIS) database was queried from 2016 to 2020 for pediatric patients with a principal diagnosis of AIS. Patients with a concurrent diagnosis of CD (AIS-CD) were compared to those without (AIS). Baseline demographics and comorbidities, clinical variables of severity, hospital complications, and the rates of tissue plasminogen activator (tPA) and mechanical thrombectomy were compared between the two groups. The main outcomes studied were mortality, discharge disposition, length of stay (LOS), and total hospital charges. (3) Results: Of 12,755 pediatric patients with a principal diagnosis of AIS, 75 (0.6%) had concurrent CD. There were no differences in the severity, discharge disposition, or mortality between the AIS-CD and AIS patients. Patients with AIS-CD were more likely to receive tPA at an outside hospital within 24 h of admission (p < 0.01) and more likely to undergo mechanical thrombectomy (p < 0.01) compared to the AIS patients. (4) Conclusions: CD patients made up only 0.6% of all pediatric AIS patients. No differences in the severity, mortality, or discharge disposition suggests a minimal to absent role of CD in the etiology of stroke. The CD-AIS patients were more likely to receive a tPA or undergo a mechanical thrombectomy; studies are needed to confirm the safety and efficacy of these interventions in pediatric patients.

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The Prevalence of Celiac Disease in Children With Arterial Ischemic Stroke

Cited by 2 publications

References 23 publications

Cardiovascular involvement in celiac disease

Cardiovascular involvement in celiac disease

Incidence, Characteristics, and Outcomes of Stroke in Pediatric Patients with Celiac Disease

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