Gastrointestinal findings in children with Down syndrome: Is there an early sign for celiac disease?

Yıl 2018, Cilt: 3 Sayı:3, 195 - 197, 30.11.2018

Halil Kocamaz , Sedat Işıkay

https://doi.org/10.25000/acem.457551

Öz

Aim: To investigate the prevalence of celiac disease
(CD) among children with Down’s syndrome (DS) and its association with
gastrointestinal symptoms and other accompanying diseases.

Methods: The study was consisted of regular trisomy 21
patients who were under follow-up in our department. The age, gender,
gastrointestinal symptoms (abdominal pain, constipation, diarrhea, abdominal
distension, vomiting, flatulence, and unsatisfactory weight gain/weight loss)
and accompanying diseases were recorded. Anti-tissue transglutaminase
(anti-tTG) immunoglobulin A (Ig A) levels were analyzed in all cases.
Serologically positive patients were referred to a pediatric gastroenterologist
for intestinal biopsy.

Results: Totally 98 children with a mean age of 3.2±2.81
years (range: 2-13 years) diagnosed with the DS were included in this study.
Among study participants, 46 (46.9%) were female. Among study participants, 3
(3.1%) had positive anti-tTG IgA results and endoscopic biopsies revealed the
diagnosis of Marsh type 3b CD in all of them. In correlation analysis,
hypothyroidism (p=0.03) and presence of diarrhea (p=0.04) significantly
correlated with the CD presence among children with the DS. Diarrhea increased
the risk for 1.50 times (0.67-3.34) while hypothyroidism increased the risk for
2.75 times (0.55-13.67) among patients with DS.

Conclusion: Clinicians should be aware of an increased
prevalence of CD among patients with DS especially in children with diarrhea
and/or hypothyroidism.

Anahtar Kelimeler

Celiac disease, children, Down syndrome

Down sendromlu çocuklarda gastrointestinal bulgular: Çölyak hastalığı için erken bir belirti var mı?

Öz

Amaç: Down sendromlu (DS) çocuklarda çölyak
hastalığının (ÇH) sıklığını ve gastrointestinal semptomlar ve eşlik eden diğer
hastalıklarla birlikteliğini saptamak.

Yöntemler: Çalışmaya kliniğimizde takip edilen regüler
trizomi 21 olan hastalar alındı. Yaş, cinsiyet, gastrointestinal semptomlar
(karın ağrısı, kabızlık, diyare, abdominal distansiyon, kusma, şişkinlik ve
kilo alımı / kilo kaybı) ve eşlik eden ek hastalıklar kaydedildi. Tüm olgularda
anti-doku transglutaminaz (anti-tTG) immünoglobulin A (IgA) düzeyleri analiz
edildi. Serolojik olarak pozitif hastalar, bağırsak biyopsisi çocuk
gastroenterolojisi tarafından yapıldı.

Bulgular: Çalışmaya yaş ortalaması 3,2 ± 2,81 yıl
(2-13 yıl) olan 98 çocuk alındı. Hastaların 46 (% 46,9) kızdı. Hastaların
3'ünde (% 3,1) anti-tTG IgA pozitifliği vardı ve endoskopik biyopsilerin
hepsinde Marsh tip 3b ÇH tanısı saptandı. ÇH saptanan DS'lu çocuklarda,
korelasyon analizinde, hipotiroidizm (p=0,03) ve diyare (p=0,04)  görülmesi anlamlıydı. DS'lu hastalarda, ishal
görülme riski 1,5 kat (0,67-3,34) artarken hipotiroidizm görülme riski 2.75 kat
(0.55-13.67) arttırdığı saptandı.

Sonuç: Klinisyenler, DS'li çocuklarda özellikle diyare
ve / veya hipotiroidili varlığında Çölyak hastalığı akılda tutulmalıdır.

Anahtar Kelimeler

Çölyak hastalığı, Down sendromu, çocuk

Kaynakça

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