Retrospective Evaluation of the Clinical Findings and Bone Mineral Densitometry Results of Children with Celiac Disease

Objective: Children diagnosed with Celiac disease should be closely followed-up for osteoporosis that may develop. We aimed to evaluate the osteoporosis conditions through bone densitometry in patients with the diagnosis of celiac disease, who were given a strict gluten-free diet. Method: The complaints at the time of admission, anthropometric data, laboratory findings at the time of admission, laboratory findings after gluten-free diet and bone densitometer results of 80 patients, who were followed-up at the pediatric gastroenterology outpatient clinic of our hospital and diagnosed with Celiac disease, were retrospectively investigated. Results: The study was conducted between December 2015 and February 2016 with patients diagnosed with Celiac disease. The study was conducted with a total of 80 cases, 31 (38.8%) boys and 49 (61.3%) girls. The mean age of the cases was 10.01±4.75 years. While the most common symptoms of the cases with gastrointestinal system findings were abdominal pain and diarrhea, the most common findings apart from the gastrointestinal system were growth and developmental delay and anemia. In our study, the frequency of osteoporosis was 14%. Conclusion: In our study, it is shown that the majority of children diagnosed with Celiac disease apply to the hospital with findings apart from the gastrointestinal system or asymptomatically. It is important to carefully question the non-gastrointestinal system findings of the disease. Requesting Bone Mineral Densitometry in the follow-up of Celiac disease is an important marker for diagnosis and increase in length of patients with osteoporosis.

Çölyak Hastalığı Olan Çocukların Klinik Bulguları ve Kemik Mineral Dansitometri Sonuçlarının Retrospektif Olarak Değerlendirilmesi

Amaç: Çölyak hastalığı tanısı almış çocuklar, gelişebilecek osteoporoz açısından yakın takipte olmalıdır. Çölyak tanısı almış ve sıkı glutensiz diyet başlanan çocukların kemik dansitometre ile osteoporoz durumları değerlendirilmesi amaçlanmıştır. Yöntem: Hastanemiz çocuk gastroenteroloji polikliniğinden takipli Çölyak hastalığı tanısı olan 80 çocuğun başvuru yakınmaları, antropometrik verileri, başvuru sırasındaki laboratuvar bulguları ile glutensiz diyet sonrası bakılan laboratuvar bulguları ve kemik dansitometre sonuçları retrospektif olarak araştırıldı. Bulgular: Çalışma Aralık 2015 ve Şubat 2016 tarihleri arasında hastanemizde Çölyak hastalığı tanılı hastalar ile yapılmıştır. Çalışma 31’i (%38,7) erkek, 49’u (%61,3) kız toplam 80 olgu ile yapılmıştır. Olguların yaş ortalaması 10,01±4,75 yıldı. Gastrointestinal sistem bulguları olan olguların en sık semptomu karın ağrısı ve ishalken, gastrointestinal sistem dışı en sık görülen bulgular büyüme gelişme geriliği ve anemi olmuştur. Çalışmamızda, osteoporoz sıklığı %14 olarak saptanmıştır. Sonuç: Çalışmamızda Çölyak hastalığı tanısı almış çocukların çoğunluğunun gastrointestinal sistem dışı bulgularla hastaneye başvurdukları veya asemptomatik oldukları gösterilmektedir. Hastalığın gastrointestinal sistem dışı bulgularının dikkatle sorgulanması önemlidir. Çölyakhastalığı takibinde Kemik Mineral Dansitometre istenmesiosteoporoz olan hastaların tanı alması ve boy uzaması açısından önemli bir belirteçtir.

Kaynakça

1. Maki M, Lohi O. Celiac Disease. In: Walker WA, Goulet O, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR (eds). Pediatric Gastrointestinal Disease. 4th ed. Ontario: B.C. Decker, 2004:932- 43.

2. Nilsen EM, Jahnsen FL, Lundin KE, Johansen FE, Fausa O, Sollid LM, et al. Gluten induces an intestinal cytokine response strongly dominated by interferon gamma in patients with celiak disease. Gastroenterology 1998;115(3):551-563.

3. Przemioslo RT, Lundin KE, Sollid LM, Nelufer J, Ciclitira PJ. Histological changes in small bowel mucosa induced by gliadin sensitive T lymphocytes can be blocked by anti-interferon gamma antibody. Gut 1995;36:874-879.

4. Molberg O, Mnadam SN, Körner R, Quarsten H, Kristiansen C, Madsen L, et al. Tissue transglutaminase selectively modifies gliadin peptides that are recognised by gut derived cells in coeliac disease. Nat Med 1998;4(6):713-717.

5. Hill ID, Bhatnagar S, Cameron DJS, De Rosa S, Maki M, Russell G, et al. Celiac Disease: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2002;35(Suppl 2):578-588.

6. Högberg L, Magnusson FK, Grodzinsky E, Stenhammar L. Familial prevalence of coeliac disease: a Twenty- Year Follow-up Study. Scand J Gastroenterol 2003;38(1):61-65.

7. Fasano A, Catassi C. Coeliac disease in children. Best Pract Res Clin Gastroenterol 2005;19:467-478.

8. Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012;54(1):136-160.

9. Akay Hacı I, Kuyum P, Çakar S, Işık İ, Arslan N. Presenting symptoms of pediatric patients with celiac disease. Abant Med J2015;4(2):146- 150.

10. Ertekin V, Selimoglu MA, Altinkaynak S. Celiac disease in childhood: evaluation of 140 patients. Eurasian J Med 2009;41(3):154-157.

11. Abaci A, Esen I, Ünüvar T, Arslan N, Bober E. Two cases presenting with pubertal delay and diagnosed as Celiac disease. Clin Pediatr (Phila) 2008;47(6):607-609.

12. Lecornu M, David L, Francois R. Low serum somatomedinactivity in celiac disease. Helv Pediatr Acta 1978;33(6):509-516.

13. Margoni D, Chouliaris G, Duscas G, VoskakiI, Voutsas N, Papadapoulou A, et al. Bone Health in Children with Celiac Disease Assesedby Dual-X-Ray Absorptiometry: Effect of Gluten Free Diet and Predictive Value of Serum Biochemical Indices. Journal Pediatr Gastroenterol Nutr 2012;54(5):680-684.

14. Kuloğlu Z, Kırsaçlıoğlu C, Kansu A, Ensari A, Girgin N. Açıklanamayan Transaminaz Yüksekliği ve Atipik Çölyak Hastalığı: Olgu Sunumu. Türkiye Çocuk Hast Derg 2008;2(2):33-38.

15. Kondolot M, Demirçeken F, Ertan Ü. 52 Vaka İle Türk Çocuklarında Çölyak Hastalığı. Türkiye Çocuk Hast Derg 2009;3(1):10-17.

16. Tau C, Mautalen C, De Rosa S, Roca A, Valenzuela X. Bone mineral density in children with celiac disease. Effect of a Gluten-free diet. Eur J Clin Nutr 2006;60(3):358-363.

17. Zanchi C, Di Leo G, Ronfani L, Martelossi S, Not T, Ventura A. Bone metabolism in celiac disease. J Pediatr 2008;153(2):262-265.18. Scotta MS, Salvatore S, Salvatoni A, De Amici M, Ghiringhelli D, BrogginiM, et al. Bone mineralization and body composition in young patients with celiac disease. Am J Gastroenterol 1997;92(8):1331-1334.

19. Turner J, Pellerin G, Mager D. Prevalence of metabolic bone disease in children with celiac disease is independent of symptoms at diagnosis. J Pediatr Gastroenterol Nutr 2009;49(5):589-593.

20. Green PH. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology 2005;128(4 Suppl 1):S74-78.

Kaynak Göster

119 123

Arşiv
Sayıdaki Diğer Makaleler

Retrospective Evaluation of the Clinical Findings and Bone Mineral Densitometry Results of Children with Celiac Disease

Sezin NAİBOĞLU, Zerrin ÖNAL

Effect of Static and Dynamic Stretching on Knee Muscle Strength in Trained Players

Chasan Mola ALİ, Filiz TUNA, Hasan Kerem ALPTEKİN, Derya DEMİRBAĞ KABAYEL, Hakan TUNA

Association of Cervical Screening Results with Colposcopic Findings

Derya KILIÇ, Tolga GÜLER

Interleukin-6 Levels in the Cervicovaginal Fluid of Pregnant Women and Its Predictive Value in Preterm Delivery

Pelin ERGENEKON

Predictive Role of Monocyte to High-density Lipoprotein Ratio for Plaque Morphology in Asymptomatic Intermediate Carotid Stenosis

Erdem KARAÇÖP, Asım ENHOŞ

Facet Dislocation Fractures of Subaxial Cervical Spine: A Treatment Algorithm for Surgical Approach Decision

Barış ÖZÖNER, Levent AYDIN, Songül Meltem CAN, Ahmet Murat MÜSLÜMAN, Adem YILMAZ

Anesthetic Management in Premature Newborn with Huge Sacrococcygeal Teratoma: A Case Report

Funda GÜMÜŞ ÖZCAN, Melahat EROL, Hasan Cem GÜNEYLİ, Serdar DEMİRGAN, Mustafa Baran YAVUZ, Nurseli TOKSOY, Ayşin SELCAN

Short-term Results of Patients Presented to the Pediatric Emergency Department with Fever

Ülkem KOÇOĞLU BARLAS

The Importance of De Ritis Ratio in Patients with Bladder Cancer

Kasım ERTAŞ, Recep ERYILMAZ, Rahmi ASLAN, Murat DEMİR, Kerem TAKEN

Assessment of the Quality and Reliability of the Information on Bone Tumor on Youtube

Sezgin Bahadır TEKİN, Erman ÖĞÜMSÖĞÜTLÜ