engleski

SILENT CELIAC DISEASE IN CHILDREN OF SHORT STATURE REVEALED BY SEROLOGICAL SCREENING

Objective: To investigate the prevalence of celiac disease (CD) in children with short stature (one of the “ atypical” CD manifestations) and to reasses the simultaneous detection of antigliadin (AGA IgA and IgG) and antiendomysium (EMA) antibodies as a screening tools. Patients and methods: A total of 81 children with short stature and no evident gastrointestinal or endocrine disorders were included in the study. IgG and IgA AGA in sera samples were detected by ELISA tests (Euroimmun, Germany and Eurospital, Italy), and IgA EMA by indirect immunofluorescence test using monkey esophagus. Total serum IgA was determined in order to not miss the cases with associated IgA deficiency. Seropositive samples underwent intestinal biopsy and HLA-typing for CD confirmation. Results: 10 out of 81 children (12, 3%) were positive for any of the serologic tests. EMA were positive in 8/10 samples (1 with EMA only, 2 together with AGA-IgG and 5 together with AGA-IgG and AGA-IgA). Two samples negative for EMA were also negative for AGA-IgA while positive for AGA-IgG and was find out to have a selective IgA deficiency. Small intestinal biopsy confirmed CD in all 10 children and 9 tested for HLA type was find out to tave a celiac type HLA markers: DR3-DQ2 (6), DR5/7-DQ2 (2) and DR4-DQ8 (1). Conclusion: The incidence of CD (12, 3%) in our group of children with short stature were in accordance with other studies. Results support the use of serologic tests for detecting patients that need an intestinal biopsy. First line of screening protocol should include serum IgA and EMA- IgA only and individuals identified as IgA deficient should undergo further testing for AGA-IgG.

silent celiac disease

nije evidentirano