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

Yıl 2018, Cilt: 19 Sayı: 4, 126 - 130, 26.10.2018

Semiha Terlemez Yavuz Tokgöz

https://doi.org/10.18229/kocatepetip.474987

Öz

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.

Anahtar Kelimeler

Celiac disease, anemia, thrombocytosis, mean platelet volume

ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ

Öz

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.

Anahtar Kelimeler

Çölyak hastalığı, Anemi, Trombositoz, Ortalama platelet hacmi

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