The evaluation of factors and symptoms related to celiac disease in Turkish children

Öz

Aim: The aim of the study is to evaluate the factors that may affect the celiac disease and symptoms related to celiac disease in school age children between the ages 6 and 17 years Material and Method: Between 2006 and 2008 20190 school age children between ages 6 and 17 mean age 11 6 plusmn;2 9 in 139 schools in 62 cities of Turkey were included into the study Celiac disease CD was screened using total serum IgA IgA anti tissue transglutaminase tTG and IgA anti endomisial EMA antibodies Subjects with selective IgA deficiency were further tested for IgG tTG Small intestinal biopsy was offered to all subjects with tTG antibody positivity The children who had intestinal biopsy compatible with CD composed celiac group Children with negative celiac antibodies composed control group Risk factors that may affect the CD and symptoms related to CD were evaluated using questionnaire in celiac and control groups Results: 215 of 489 children with antibody positivity approved intestinal biopsy nbsp; Celiac disease was confirmed by histopathology in 95 subjects celiac group In 19701 children celiac antibodies were found to be negative control group The mean age of the children in celiac and control group was similar 11 7 plusmn;2 8 vs 11 6 plusmn;2 9 respectively p gt;0 05 The ratio of girls was significantly higher in celiac group than controls 61 64 2 vs 10092 51 2 respectively p=0 012 There were no significant differences about gastrointestinal symptoms between groups p gt;0 05 Extraintestinal symptoms including loss of appetite history of pica and short stature were found to be significantly higher in children with CD p=0 007 p=0 012 and p=0 011; respectively Conclusions: It was concluded that CD is more common in girls and mostly presented with extraintestinal symptoms among 6 to 17 years old children in Turkey Turk Arch Ped 2011; 46: 323 30

Anahtar Kelimeler

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Türk çocuklarında çölyak hastalığı ile ilişkili olası etmen ve belirtilerin değerlendirilmesi

Öz

Amaç: Türkiye rsquo;de 6 17 yaş grubu okul çağı çocuklarında çölyak hastalığının ÇH ortaya çıkışını etkileyebilecek etmenler ve hastalığı işaret edebilecek belirtiler araştırılmıştır.

Gereç ve Yöntem: 2006 2008 yılları arasında Türkiye rsquo;de 63 ilde 139 okulda yaşları 6 17 arasında ort 11 6 plusmn;2 9 yıl toplam 20 190 okul çağı çocuğu çalışmaya alınmıştır Çölyak hastalığı tanısında serolojik olarak total serum IgA doku transglütaminaz IgA ve endomizyal IgA kullanılmış ve selektif IgA eksikliği olanlarda doku transglütaminaz IgG bakılmıştır Antikor pozitifliği saptanan tüm olgulara ince bağırsak biyopsisi önerilmiş ve biyopsi yapılarak ÇH tanısı kanıtlanan olgular çölyak grubunu antikor testleri negatif olgular kontrol grubunu oluşturmuştur Çocukların demografik özellikleri ile ÇH rsquo; de görülebilecek belirtiler anket formlarına kaydedilerek ÇH rsquo;nin ortaya çıkışını etkileyebilecek risk etmenleri ve klinik belirtiler açısından gruplar karşılaştırılmıştır Çalışma protokolü Gazi Üniversitesi Tıp Fakültesi Yerel Etik Kurulu tarafından onaylanmıştır 12 05 2011 103.

Bulgular: Antikor testlerinde pozitiflik saptanan 489 olgudan 215 rsquo;i ince bağırsak biyopsisi yapılmasını kabul etti Histopatolojik olarak ÇH kanıtlanan 95 olgu çölyak grubunu serolojik testleri negatif 19 701 olgu ise kontrol grubunu oluşturmuştur Olguların yaş ortalaması çölyak grubunda 11 7 plusmn;2 8 kontrol grubunda 11 6 plusmn;2 9 olup bu açıdan gruplar arasında fark bulunmamıştır p gt;0 05 Çölyak grubunda 61 rsquo;i 64 2 kontrol grubunda ise 10 092 rsquo;si 51 2 kız öğrenci olup kızlar çölyak grubunda anlamlı oranda fazla bulunmuştur p=0 012 Sindirim sistemine ait belirtiler bakımından gruplar arasında anlamlı fark saptanmamıştır p gt;0 05 Sindirim sistemi dışı bulgulardan iştahsızlık pika öyküsü ve boy kısalığı çölyak grubunda kontrol grubuna göre anlamlı oranda yüksek bulunmuştur p lt;0 05.

Çıkarımlar: Türkiye rsquo;de literatüre benzer şekilde hastalığın kız cinsiyette daha fazla olduğu ve 6 17 yaş grubu çocuklarda ÇH rsquo;nin klinik sunumunun daha çok sindirim sistemi dışı belirtilerle olduğu sonucuna varılmıştır.

Anahtar Kelimeler

• Belirtiler
• çocuk
• çölyak hastalığı
• risk

Kaynakça

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