Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2011
Student: BEYZA ÖZCAN
Supervisor: BUKET DALGIÇ
Abstract:Evaluation of factors and symptoms that may be related to celiac disease in school age children between the ages 6 and 17 in Turkey Celiac disease is an autoimmune enteropathy, triggered by gluten in individuals with genetic predisposition. The disease may presents with gastrointestinal or extraintestinal symptoms. In recent years, there is significant changes in the prevalence and clinical properties of the celiac disease. In this study, we investigated the effective factors for emerging the disease and symptoms suggesting to the celiac disease in school age children between the ages 6 and 17 in Turkey. For this purpose, 20190 school age children between the ages 6 and 17 and with an average age of 11.6 ± 2.9 are included in the study. To screen the disease, first, total serum immunoglobulin A and tissue transglutaminase IgA were studied. Tissue transglutaminase IgG were measured in patients with total IgA deficiency. Cases with a positive tissue transglutaminase IgA and IgG were retested with IgA anti- antiendomisyal antibody. İntestinal biopsy was accepted by 215 out of 489 antibody positive subjects (only tTG IgA positive: 110 patients, both tTG IgA and EMA IgA positive: 104 patients, and tTG IgG positive: 1 patient). The celiac disease was comfirmed by histopathology in 95 children (celiac disease group ). In 19701 children celiac antibodies were found to be negative (control group). The average age of the groups were similar ( 11.7 ± 2.8 vs 11.6 ± 2.9 years). The ratio of girls (64.2%) was higher than controls in the celiac disease group (p=0.012). There were no differences between the groups regarding the possible factors related the disease: the duration of breastfeeding, the time to start solids, and family history of similar disease. Gastrointestinal symptoms of diarrhea, weight loss, abdominal distension, abdominal pain, gas and constipation were observed with similar frequencies in both groups. There were no differences between the groups for extraintestinal symptoms such as school success, tiredness, restlessness, unhappiness and irritability. Suffering from pica, which may be an indirect indicator of iron deficiency, was more common among celiac patients than the control group (p=0.012). Loss of appetite were observed significantly more in the celiac group (p=0.007). Short stature, among the extraintestinal symptoms, were significantly more common in the celiac group than the control group (p=0.011). In the multi-variable regression analysis, a positive correlation was determined between the diagnosis of celiac disease, and especially the presence of pica, female gender, loss of appetite and short stature. Those with low income and education levels answered "yes" more frequently to the questions in the survey, and this was statistically significant. However, parents with elementary school and lower education levels and with low incomes did not have a significant impact on the celiac disease. With these results, it was determined that celiac disease is more common in girls and presented with mostly extraintestinal symptoms among 6 to 17 year old children in Turkey.