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A NEW MARKER IN CELIAC DISEASE DIET ADAPTATION: DELTA NEUTROPHIL INDEX?

Year 2021, Volume: 22 Issue: 4, 294 - 299, 01.07.2021
https://doi.org/10.18229/kocatepetip.864099

Abstract

OBJECTIVE: Celiac Disease is an enteropathy caused by the consumption of foods containing gluten and characterized by autoimmune events in the small intestine. In our study, we aimed to show the relationship between the activation criteria that increased with dietary incompatibility and the delta neutrophil index in celiac disease.
MATERIAL AND METHODS: In this study, between January 2019 and December 2019, 99 children and adolescents (under the age of 18) who were admitted to the Sami Ulus Maternity and Children's Hospital pediatric gastroenterology outpatient clinic and previously diagnosed with celiac disease were included.
RESULTS: A total of 99 celiac patients between the ages of 3 - 17, 45 girls (45.5%) and 54 boys (54.5%), were included in the study. There was no significant relationship between Delta Neutrophil Index (DNI) and duration of diagnosis (p = 0.094 r = 0.169)., dTGA (p = 0.256 r = 0.115), dTGG (p = 0.359 r = -0.094) and IgA (p = 0.259 r = 0.115).
CONCLUSIONS: Early diagnosis and treatment of celiac disease are very important because after a gluten-free diet, both symptoms regress and the development of more severe celiac-related damage can be prevented. The serological tests used to determine the dietary compliance of the patients during the follow-up were compared with the DNI level, which is one of the routine hemogram parameters used in many inflammatory conditions, but no statistically significant relationship was found. Dietary compliance can be determined by further studies in the follow-up of celiac patients.

References

  • 1. Moore JK, West SR, Robins G. Advances in celiac disease. Curr Opin Gastroenterol 2011; 27(2):112-118.
  • 2. Dewar D, Pereira SP, Ciclitira PJ. The pathogenesis of celiac disease. Int J Biochem Cell Biol 2004; 36(1): 17-24.
  • 3. Maiuri L, Ciacci C, Ricciardelli I, et al. Association between innate response to gliadin and activation of pathogenic T cells in coeliac disease. Lancet 2003; 362(9377): 30-37.
  • 4. Salvati VM, Mac Donald TT, Blanco GV, et al. Enhanced expression of interferon regulatory factor-1 in the mucosa of children with celiac disease. Pediatr Res 2008; 54(3): 312-318.
  • 5. Dotson JL, Crandall WV, Zhang P, et al. Feasibility and Validity of the Pediatric Ulcerative Colitis Activity Index in Routine Clinical Practice. J Pediatr Gastroenterol Nutr 2015 ; 60(2): 200–204.
  • 6. Hyams JS, Ferry GD, Mandel FS, et al. Development and validation of a pediatric Crohn's disease activity index. J Pediatr Gastroenterol Nutr 1991; 12(4) : 439-447.
  • 7. Sydora MJ, Sydora BC, Fedorak RN. Validation of a point-of-care) desk top device toquantitate fecal calprotectin and distinguish inflammatory bowel disease from irritable bowel syndrome. J Crohns Colitis 2012; 6(2): 207-214.
  • 8. Atkinson M, Leonard MB, Herskovitz R, Baldassano RN , Denburg MR. Changes in Hepcidin and Hemoglobin After anti-TNF-alpha Therapy in Children and Adolescents with Crohn’s Disease. J Pediatr Gastroenterol Nutr 2018; 66(1): 90-94.
  • 9. Uysal NŞ, Eroğlu H, Özcan Ç, Sahin D, Yucel A. Is the serum delta neutrophil index level different in gestational diabetic women? J Matern Fetal Neonatal Med 2020 ;33(19):3349-3354.
  • 10. Macdonald S (Editor). Gastroenterology. In: Shaw V, Lawson M. Clinical Paediatric Dietetics. 3rd ed. Oxford: Blackwell Publishing 2007: p. 100-3.
  • 11. Novacek G, Miehsler W, Wrba F, Ferenci P, Penner E, Vogelsang H. Prevalence and clinical importance of hypertransaminasaemia in coeliac disease. Eur J Gastroenterol Hepatol 1999;11(3):283-288.
  • 12. Hill ID, Dirks MH, Liptak GS, et al. Guideline for the diagnosis and treatment of celiac disease in children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005; 40(1): 1-19.
  • 13. Husby S, Koletzko S, Korponay-Szabó IR, et al. ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54(1): 136-160.
  • 14. Dahlbom I, Korponay-Szabo IR, Kovacs JB, Szalai Z, Mäki M, Hansson T. Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. J Pediatr Gastroenterol Nutr 2010;50(2):140–146.
  • 15. Hill PG, Holmes GK. Coeliac disease: A biopsy is not always necessary for diagnosis. Aliment Pharmacol Ther 2008;27(7):572–575.
  • 16. Vivas S, Ruiz de Morales JG, et al. Duodenal biopsy may be avoided when high transglutaminase antibody titers are present. World J Gastroenterol 2009;15(38):4775–4780.
  • 17. Cataldo F, Marino V, Ventura A, Bottaro G, Corazza GR. Prevalence and clinical features of selective immunoglobulin A deficiency in coeliac disease: an Italian multicentre study. Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP) and ‘Club del Tenue’ Working Groups on Coeliac Disease. Gut 1998; 42(3): 362-365.
  • 18. Hammarstrom L (Editor). Genetic approach to common variable immunodeficiency and IgA deficiency. In: Ochs H, Smith CIE, Puck J. Primary Immunodeficiency Diseases, A Molecular and Genetic Approach. 1 st ed, Oxford, Oxford University Press 1999: pp. 250-262.
  • 19. Murray JA. Celiac disease in patients with an affected member, type 1 diabetes, iron-deficiency, or osteoporosis? Gastroenterology 2005; 128(1): 52-56.
  • 20. Doganci T, Bozkurt S. Celiac disease with various presentations. Pediatr Int 2004; 46(6):693-696.

ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?

Year 2021, Volume: 22 Issue: 4, 294 - 299, 01.07.2021
https://doi.org/10.18229/kocatepetip.864099

Abstract

AMAÇ: Çölyak Hastalığı, gluten içeren yiyeceklerin tüketilmesi ile oluşan ve ince bağırsakta otoimmün olaylarla karakterize bir enteropatidir. Çalışmamızda, çölyak hastalığında diyet uyumsuzluğu ile artış gösteren aktivasyon kriterleri ile delta nötrofil indeks arasındaki ilişkinin gösterilmesi amaçlandı.
GEREÇ VE YÖNTEM: Bu çalışmada, Ocak 2019 ve Aralık 2019 tarihleri arasında Dr. Sami Ulus Kadın Doğum ve Çocuk Hastanesi pediatrik gastroenteroloji polikliniğine başvuran önceden çölyak hastalığı tanısı almış olan 99 çocuk ve ergen (18 yaş altı) dahil edildi.
BULGULAR: Çalışmaya 45’i kız (% 45.5), 54’ü erkek (% 54.5) olmak üzere 3 - 17 yaş arası toplam 99 çölyak hastası dahil edildi. Delta Nötrofil İndeksi (DNI) ile tanı süresi arasında (p=0,094 r=0,169), dTGA ile (p=0,256 r=0,115), dTGG ile (p=0,359 r=-0,094) ve IgA ile anlamlı bir ilişki saptanmadı (p=0,259 r=0,115).
SONUÇ: Çölyak hastalığının erken tanınıp tedavi edilmesi çok önemlidir çünkü glütensiz diyet sonrası hem semptomlar gerilemekte hem de daha ciddi çölyak ilişkili hasarların gelişmesi önlenebilmektedir. Hastaların takipte diyet uyumunu belirlemek için kullanılan serolojik testler, bir çok inflamatuar durumda kullanılan ve rutin hemogram parametrelerinden biri olan DNI düzeyi ile karşılaştırıldı ancak istatistiksel olarak anlamlı ilişki saptanmadı. Çölyak hastalarının takibinde diyet uyumu ileri çalışmalar ile belirlenebilir.

References

  • 1. Moore JK, West SR, Robins G. Advances in celiac disease. Curr Opin Gastroenterol 2011; 27(2):112-118.
  • 2. Dewar D, Pereira SP, Ciclitira PJ. The pathogenesis of celiac disease. Int J Biochem Cell Biol 2004; 36(1): 17-24.
  • 3. Maiuri L, Ciacci C, Ricciardelli I, et al. Association between innate response to gliadin and activation of pathogenic T cells in coeliac disease. Lancet 2003; 362(9377): 30-37.
  • 4. Salvati VM, Mac Donald TT, Blanco GV, et al. Enhanced expression of interferon regulatory factor-1 in the mucosa of children with celiac disease. Pediatr Res 2008; 54(3): 312-318.
  • 5. Dotson JL, Crandall WV, Zhang P, et al. Feasibility and Validity of the Pediatric Ulcerative Colitis Activity Index in Routine Clinical Practice. J Pediatr Gastroenterol Nutr 2015 ; 60(2): 200–204.
  • 6. Hyams JS, Ferry GD, Mandel FS, et al. Development and validation of a pediatric Crohn's disease activity index. J Pediatr Gastroenterol Nutr 1991; 12(4) : 439-447.
  • 7. Sydora MJ, Sydora BC, Fedorak RN. Validation of a point-of-care) desk top device toquantitate fecal calprotectin and distinguish inflammatory bowel disease from irritable bowel syndrome. J Crohns Colitis 2012; 6(2): 207-214.
  • 8. Atkinson M, Leonard MB, Herskovitz R, Baldassano RN , Denburg MR. Changes in Hepcidin and Hemoglobin After anti-TNF-alpha Therapy in Children and Adolescents with Crohn’s Disease. J Pediatr Gastroenterol Nutr 2018; 66(1): 90-94.
  • 9. Uysal NŞ, Eroğlu H, Özcan Ç, Sahin D, Yucel A. Is the serum delta neutrophil index level different in gestational diabetic women? J Matern Fetal Neonatal Med 2020 ;33(19):3349-3354.
  • 10. Macdonald S (Editor). Gastroenterology. In: Shaw V, Lawson M. Clinical Paediatric Dietetics. 3rd ed. Oxford: Blackwell Publishing 2007: p. 100-3.
  • 11. Novacek G, Miehsler W, Wrba F, Ferenci P, Penner E, Vogelsang H. Prevalence and clinical importance of hypertransaminasaemia in coeliac disease. Eur J Gastroenterol Hepatol 1999;11(3):283-288.
  • 12. Hill ID, Dirks MH, Liptak GS, et al. Guideline for the diagnosis and treatment of celiac disease in children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005; 40(1): 1-19.
  • 13. Husby S, Koletzko S, Korponay-Szabó IR, et al. ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54(1): 136-160.
  • 14. Dahlbom I, Korponay-Szabo IR, Kovacs JB, Szalai Z, Mäki M, Hansson T. Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. J Pediatr Gastroenterol Nutr 2010;50(2):140–146.
  • 15. Hill PG, Holmes GK. Coeliac disease: A biopsy is not always necessary for diagnosis. Aliment Pharmacol Ther 2008;27(7):572–575.
  • 16. Vivas S, Ruiz de Morales JG, et al. Duodenal biopsy may be avoided when high transglutaminase antibody titers are present. World J Gastroenterol 2009;15(38):4775–4780.
  • 17. Cataldo F, Marino V, Ventura A, Bottaro G, Corazza GR. Prevalence and clinical features of selective immunoglobulin A deficiency in coeliac disease: an Italian multicentre study. Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP) and ‘Club del Tenue’ Working Groups on Coeliac Disease. Gut 1998; 42(3): 362-365.
  • 18. Hammarstrom L (Editor). Genetic approach to common variable immunodeficiency and IgA deficiency. In: Ochs H, Smith CIE, Puck J. Primary Immunodeficiency Diseases, A Molecular and Genetic Approach. 1 st ed, Oxford, Oxford University Press 1999: pp. 250-262.
  • 19. Murray JA. Celiac disease in patients with an affected member, type 1 diabetes, iron-deficiency, or osteoporosis? Gastroenterology 2005; 128(1): 52-56.
  • 20. Doganci T, Bozkurt S. Celiac disease with various presentations. Pediatr Int 2004; 46(6):693-696.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Nilgün Eroğlu 0000-0002-9956-4054

Gülseren Evirgen Şahin 0000-0001-6146-3509

Ferda Özbay Hoşnut 0000-0002-4549-7474

Gürses Şahin 0000-0003-0959-1655

Publication Date July 1, 2021
Acceptance Date April 12, 2021
Published in Issue Year 2021 Volume: 22 Issue: 4

Cite

APA Eroğlu, N., Evirgen Şahin, G., Özbay Hoşnut, F., Şahin, G. (2021). ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?. Kocatepe Tıp Dergisi, 22(4), 294-299. https://doi.org/10.18229/kocatepetip.864099
AMA Eroğlu N, Evirgen Şahin G, Özbay Hoşnut F, Şahin G. ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?. KTD. July 2021;22(4):294-299. doi:10.18229/kocatepetip.864099
Chicago Eroğlu, Nilgün, Gülseren Evirgen Şahin, Ferda Özbay Hoşnut, and Gürses Şahin. “ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?”. Kocatepe Tıp Dergisi 22, no. 4 (July 2021): 294-99. https://doi.org/10.18229/kocatepetip.864099.
EndNote Eroğlu N, Evirgen Şahin G, Özbay Hoşnut F, Şahin G (July 1, 2021) ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?. Kocatepe Tıp Dergisi 22 4 294–299.
IEEE N. Eroğlu, G. Evirgen Şahin, F. Özbay Hoşnut, and G. Şahin, “ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?”, KTD, vol. 22, no. 4, pp. 294–299, 2021, doi: 10.18229/kocatepetip.864099.
ISNAD Eroğlu, Nilgün et al. “ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?”. Kocatepe Tıp Dergisi 22/4 (July 2021), 294-299. https://doi.org/10.18229/kocatepetip.864099.
JAMA Eroğlu N, Evirgen Şahin G, Özbay Hoşnut F, Şahin G. ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?. KTD. 2021;22:294–299.
MLA Eroğlu, Nilgün et al. “ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?”. Kocatepe Tıp Dergisi, vol. 22, no. 4, 2021, pp. 294-9, doi:10.18229/kocatepetip.864099.
Vancouver Eroğlu N, Evirgen Şahin G, Özbay Hoşnut F, Şahin G. ÇÖLYAK HASTALIĞI DİYET UYUMUNDA YENİ BİR BELİRTEÇ: DELTA NÖTROFİL İNDEKS?. KTD. 2021;22(4):294-9.

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