Prevalence and Clinical Features of Celiac Disease in Healthy School-Aged Children

• Published in: Digestive diseases and sciences Vol. 64; no. 1; pp. 173 - 181
• Main Authors: Beser, Omer Faruk, Gulluelli, Emine, Cullu Cokugras, Fugen, Erkan, Tulay, Kutlu, Tufan, Yagci, Rasit Vural, Erbek Alp, Firuze, Ercal, Gulten, Kepil, Nuray, Kucur, Mine
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.01.2019; Springer; Springer Nature B.V
• Subjects: Age of Onset; Autoantibodies - blood; B cells; Biochemistry; Biopsy; Case-Control Studies; Celiac disease; Celiac Disease - blood; Celiac Disease - diagnosis; Celiac Disease - epidemiology; Celiac Disease - immunology; Child; Children's furniture; Cyprus - epidemiology; Female; Gastroenterology; GTP-Binding Proteins - immunology; Hepatology; Humans; IgA Deficiency - epidemiology; Immunoglobulin A; Immunoglobulin A - blood; Immunoglobulin G; Immunoglobulin G - blood; Intestine, Small - pathology; Male; Medicine; Medicine & Public Health; Oncology; Original Article; Prevalence; Prevalence studies (Epidemiology); Serologic Tests; Transglutaminases - immunology; Transplant Surgery; Cyprus; Celiac disease; Prevalence; Children; IgA anti-tissue transglutaminase
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-018-5320-0

Background/Aims The aim of this study was to determine the prevalence of celiac disease (CD) in healthy school-aged children in the northern region of Cyprus and to investigate the existence of potential markers that may accompany CD. This is the first study to measure the prevalence of CD in the northern region of Cyprus. Methods This study included 3792 school-aged children who were between the ages of 6 and 10 years between January 2015 and October 2016. CD was screened using total serum IgA, IgA anti-tissue transglutaminase (tTG), and IgA antiendomysial (EMA) antibodies. Subjects with selective IgA deficiency were further tested for IgG-tTG. Small intestinal biopsies were performed on all subjects with tTG antibody positivity. Risk factors and symptoms related to CD were evaluated using questionnaires in both the CD and control groups. Results Of the 3792 subjects, 39 were antibody positive (IgA-tTG was positive only in 14 subjects, IgA-tTG plus IgA-EMA in 21 subjects, and IgG-tTG in 4 subjects). IgA deficiency was detected in 11 subjects (0.29%). IgG-tTG was positive in 4 subjects with IgA deficiency (36.3%). Intestinal biopsies were performed on 28 of the 39 seropositive subjects. The biopsy findings of 15 children were consistent with CD (IgA-tTG positive in 3, IgA-tTG and IgA-EMA positive in 10, and IgG-tTG positive in 2). Thus, biopsies confirmed CD in 1:256 children (0.39%). Conclusions Our study, which is the first study of school-aged children from the northern region of Cyprus, revealed that CD is a prevalent disease in this region.