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EFFECTS OF GLUTEN-FREE DIET ON HEMATOLOGICAL PARAMETERS IN CHILDREN WITH CELIAC DISEASE

Year 2018, Volume: 19 Issue: 4, 126 - 130, 26.10.2018
https://doi.org/10.18229/kocatepetip.474987

Abstract

OBJECTIVE: This study aims to evaluate the effects on

hematological parameters of the gluten-free diet in

celiac disease children.


MATERIAL AND METHODS: Firstly, children with celiac

disease were identified in our clinic. Then, retrospectively,

among these patients who were able to perform

gluten-free diet correctly were specified. Hematological

parameters of these patients were compared during the

diagnosis and 6 months after the gluten-free diet.


RESULTS: Sixty-seven of 97 children with celiac disease

were included in the study. Forty-four patients were

female (66.7%), 22 patients were male (33.3%) and the

mean age of diagnosis was 7.1 ± 4.2 years. The most common

hematologic disorders in patients were thrombocytosis

in 38 patients (57.5%) and anemia in 28 patients

(42.2%). Twenty-four patients with anemia (36.6%) had

iron deficiency anemia, two patients with anemia (3%)

had folate deficiency and one patient with anemia (1.5%)

had vitamin B12 deficiency. After 6 months of gluten-free

diet, only 8 patients (13%) had anemia. After the gluten-

free diet, platelet counts decreased from 351.2 ± 11.0

(103 / μL) to 310.5 ± 82.0 (103 / μL), leukocyte count decreased

from 8.82 ± 3.04 (103 / μL) to 8.04 ± 2.56 and mean

platelet volume decreased from 10.08 ± 1.07 fl to 9.5 ±

1.19 fl. It was determined that there was a significant increase

in hemoglobin, mean corpuscular volume and red

cell distribution width values.


CONCLUSIONS: The most common hematological

findings in children with celiac disease are thrombocytosis

and anemia. An improvement has been observed

in anemia after gluten-free diet. In addition, many

hemostasis parameters have been improved with the

gluten-free diet.

References

  • 1. Guandalini S, Setty M. Celiac disease. Curr Opin Gastroenterol. 2008;24:707–12.
  • 2. Setty M, Hormaza L, Guandalini S. Celiac disease: risk assessment, diagnosis, and monitoring. Mol Diagn Ther 2008;289–98.
  • 3. Harper JW, Holleran SF, Ramakrishnan R, Bhagat G,Green PH. Anemia in celiac disease is multifactorial in etiology. Am J Hematol 2007;996–1000.
  • 4. Jones S, D’Souza C, Haboubi NY. Patterns of clinical presentation of adult coeliac disease in a rural setting.Nutr J 2006;24.
  • 5. Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood 2007;412–21.
  • 6. Morello F, Ronzani G, Cappellari F. Migraine, cortical blindness, multiple cerebral infarctions and hypocoagulopathy in celiac disease. Neurol Sci 2003;85–9.
  • 7. McNeill A, Duthie F, Galloway DJ. Small bowel infarction in a patient with coeliac disease. J Clin Pathol 2006;216–18.
  • 8. Croese J, Harris O, Bain B. Coeliac disease. Haematological features, and delay in diagnosis. Med J Aust 1979;335–8.
  • 9. Carroccio A, Giannitrapani L, Di Prima L, Iannitto E,Montalto G, Notarbartolo A. Extreme thrombocytosis as a sign of coeliac disease in the elderly: case report. Eur JGastroenterol Hepatol 2002;897–900.
  • 10. Çatal F, Topal E, Ermiştekin H, Yildirim Acar N, Sinanoğlu MS, Karabiber H, Selimoğlu MA The hematologic manifestations of pediatric celiac disease at the time of diagnosis and efficiency of gluten-free diet. Turk J Med Sci. 2015;45(3):663-7.
  • 11. Mohamed M.Functional hyposplenism diagnosed by blood film examination. Blood. 201418;124(12):1997.
  • 12. Goyens P, Brasseur D, Cadranel S. Copper deficiency in infants with active celiac disease. J Pediatr Gastroenterol Nutr 1985;677–80.
  • 13. Voigt W, Jordan K, Sippel C, Amoury M, Schmoll HJ,Wolf HH. Severe thrombocytosis and anemia associatedwith celiac disease in a young female patient: a case report. J Med Case Reports 2008;96.
  • 14. Zipser RD, Patel S, Yahya KZ, Baisch DW, Monarch E: Presentations of adult celiac disease in a nationwide patient support group. Dig Dis Sci 2003, 48:761-4
  • 15. Yuksel O, Helvaci K, Basar O, Koklu S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009;20: 277–81.
  • 16. Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D,Spanoudakis E, Bourikas G, et al. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology. 2004;4:22–7.
  • 17. Purnak T, Efe C, Yuksel O, Beyazit Y, Ozaslan E, Altiparmak E. Mean platelet volume could be a promising biomarker to monitor dietary compliance in celiac disease. Ups J Med Sci. 2011116(3):208-11
  • 18. Maurizio G, Angelo S, Giovanni G, Paolo P, Antonio G.Latent coeliac disease, hyperhomocysteinemia and pulmonary thromboembolism: a close link. Thromb Haemost 2003;203–4.
  • 19. Rakesh K, Ibrahim M, Usha D, Singhal M, Amit M,Paramjeet S, et al. Celiac disease and budd chiari syndrome:report of a case with review of the literature. Eur J GastroenterolHepatol 2009;1092–4

ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ

Year 2018, Volume: 19 Issue: 4, 126 - 130, 26.10.2018
https://doi.org/10.18229/kocatepetip.474987

Abstract

AMAÇ: Çölyak hastalıklı çocuklarda glutensiz diyetin hematolojik
parametreler üzerindeki etkilerini değerlendirmek
amaçlanmıştır.

GEREÇ VE YÖNTEM: Öncelikle kliniğimizde çölyak hastalığı
tanısı almış olan çocuk hastalar belirlenmiştir. Daha
sonra retrospektif olarak bu hastalar arasında glutensiz
diyeti doğru şekilde uygulayabilmiş hastalar belirlenmiştir.
Bu hastaların tanı sırasında ve glutensiz diyetten 6 ay
sonra hematolojik parametreleri karşılaştırılmıştır.

BULGULAR: Çölyak hastalığı konulmuş 97 çocuk
hastadan 66’sı çalışmaya dahil edilmiştir. Hastaların
44’ü kız (%66.7), 22’si erkek (%33.3) olup tanı yaşları
ortalama 7.1 ± 4.2 yıl olarak saptanmıştır. Hastalarda
en sık saptanan hematolojik bozukluklar, sırasıyla 38
hastada (%57.5) trombositoz ve 28 hastada (%42.2)
anemi olmuştur. Anemilerin 24’ü (%36.6) demir eksikliği
anemisi, 2’si (%3) folat eksikliği anemisi, 1’i (%1.5) vitamin
B12 eksikliği anemisi olarak değerlendirilmiştir. Altı ay
devam eden glutensiz diyetten sonra anemi sıklığı 8
hastaya (%13) düşmüştür. Glutensiz diyet sonrasında
trombosit sayısı 351.2 ± 11.0 (103/μL)’den 310.5 ± 82.0
(103/μL) değerine, lökosit sayısı 8.82 ± 3.04 (103/μL)’den
8.04 ± 2.56 (103/μL)’ye, ortalama platelet hacmi 10.1 ±1.1
fl’den 9.5 ± 1.2 fl değerlerine düşmüştür. Buna karşılık;
hemoglobin, ortalama korpuskuler volüm ve eritrosit
dağılım genişliği değerlerinde ise anlamlı derecede artış
olduğu görülmüştür.

SONUÇ: Çölyak hastası çocuklarda en sık saptanan
hematolojik bulgular, trombositoz ve anemi olmuştur.
Glutensiz diyet sonrasında anemide düzelme olduğu
görülmektedir. Bundan başka, hemostazda etkili birçok
parametrenin de glutensiz diyetle birlikte düzeldiği
gözlenmiştir.

References

  • 1. Guandalini S, Setty M. Celiac disease. Curr Opin Gastroenterol. 2008;24:707–12.
  • 2. Setty M, Hormaza L, Guandalini S. Celiac disease: risk assessment, diagnosis, and monitoring. Mol Diagn Ther 2008;289–98.
  • 3. Harper JW, Holleran SF, Ramakrishnan R, Bhagat G,Green PH. Anemia in celiac disease is multifactorial in etiology. Am J Hematol 2007;996–1000.
  • 4. Jones S, D’Souza C, Haboubi NY. Patterns of clinical presentation of adult coeliac disease in a rural setting.Nutr J 2006;24.
  • 5. Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood 2007;412–21.
  • 6. Morello F, Ronzani G, Cappellari F. Migraine, cortical blindness, multiple cerebral infarctions and hypocoagulopathy in celiac disease. Neurol Sci 2003;85–9.
  • 7. McNeill A, Duthie F, Galloway DJ. Small bowel infarction in a patient with coeliac disease. J Clin Pathol 2006;216–18.
  • 8. Croese J, Harris O, Bain B. Coeliac disease. Haematological features, and delay in diagnosis. Med J Aust 1979;335–8.
  • 9. Carroccio A, Giannitrapani L, Di Prima L, Iannitto E,Montalto G, Notarbartolo A. Extreme thrombocytosis as a sign of coeliac disease in the elderly: case report. Eur JGastroenterol Hepatol 2002;897–900.
  • 10. Çatal F, Topal E, Ermiştekin H, Yildirim Acar N, Sinanoğlu MS, Karabiber H, Selimoğlu MA The hematologic manifestations of pediatric celiac disease at the time of diagnosis and efficiency of gluten-free diet. Turk J Med Sci. 2015;45(3):663-7.
  • 11. Mohamed M.Functional hyposplenism diagnosed by blood film examination. Blood. 201418;124(12):1997.
  • 12. Goyens P, Brasseur D, Cadranel S. Copper deficiency in infants with active celiac disease. J Pediatr Gastroenterol Nutr 1985;677–80.
  • 13. Voigt W, Jordan K, Sippel C, Amoury M, Schmoll HJ,Wolf HH. Severe thrombocytosis and anemia associatedwith celiac disease in a young female patient: a case report. J Med Case Reports 2008;96.
  • 14. Zipser RD, Patel S, Yahya KZ, Baisch DW, Monarch E: Presentations of adult celiac disease in a nationwide patient support group. Dig Dis Sci 2003, 48:761-4
  • 15. Yuksel O, Helvaci K, Basar O, Koklu S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009;20: 277–81.
  • 16. Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D,Spanoudakis E, Bourikas G, et al. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology. 2004;4:22–7.
  • 17. Purnak T, Efe C, Yuksel O, Beyazit Y, Ozaslan E, Altiparmak E. Mean platelet volume could be a promising biomarker to monitor dietary compliance in celiac disease. Ups J Med Sci. 2011116(3):208-11
  • 18. Maurizio G, Angelo S, Giovanni G, Paolo P, Antonio G.Latent coeliac disease, hyperhomocysteinemia and pulmonary thromboembolism: a close link. Thromb Haemost 2003;203–4.
  • 19. Rakesh K, Ibrahim M, Usha D, Singhal M, Amit M,Paramjeet S, et al. Celiac disease and budd chiari syndrome:report of a case with review of the literature. Eur J GastroenterolHepatol 2009;1092–4
There are 19 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Semiha Terlemez This is me

Yavuz Tokgöz This is me

Publication Date October 26, 2018
Acceptance Date December 20, 2017
Published in Issue Year 2018 Volume: 19 Issue: 4

Cite

APA Terlemez, S., & Tokgöz, Y. (2018). ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ. Kocatepe Tıp Dergisi, 19(4), 126-130. https://doi.org/10.18229/kocatepetip.474987
AMA Terlemez S, Tokgöz Y. ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ. KTD. October 2018;19(4):126-130. doi:10.18229/kocatepetip.474987
Chicago Terlemez, Semiha, and Yavuz Tokgöz. “ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ”. Kocatepe Tıp Dergisi 19, no. 4 (October 2018): 126-30. https://doi.org/10.18229/kocatepetip.474987.
EndNote Terlemez S, Tokgöz Y (October 1, 2018) ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ. Kocatepe Tıp Dergisi 19 4 126–130.
IEEE S. Terlemez and Y. Tokgöz, “ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ”, KTD, vol. 19, no. 4, pp. 126–130, 2018, doi: 10.18229/kocatepetip.474987.
ISNAD Terlemez, Semiha - Tokgöz, Yavuz. “ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ”. Kocatepe Tıp Dergisi 19/4 (October 2018), 126-130. https://doi.org/10.18229/kocatepetip.474987.
JAMA Terlemez S, Tokgöz Y. ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ. KTD. 2018;19:126–130.
MLA Terlemez, Semiha and Yavuz Tokgöz. “ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ”. Kocatepe Tıp Dergisi, vol. 19, no. 4, 2018, pp. 126-30, doi:10.18229/kocatepetip.474987.
Vancouver Terlemez S, Tokgöz Y. ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ. KTD. 2018;19(4):126-30.

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