Prevalence and Clinical Features of Celiac Disease in Healthy School-Aged Children
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The aim of this study was to determine the prevalence of celiac disease (CD) in healthy school-aged children in the northern region of Cyprus and to investigate the existence of potential markers that may accompany CD. This is the first study to measure the prevalence of CD in the northern region of Cyprus.
This study included 3792 school-aged children who were between the ages of 6 and 10 years between January 2015 and October 2016. CD was screened using total serum IgA, IgA anti-tissue transglutaminase (tTG), and IgA antiendomysial (EMA) antibodies. Subjects with selective IgA deficiency were further tested for IgG-tTG. Small intestinal biopsies were performed on all subjects with tTG antibody positivity. Risk factors and symptoms related to CD were evaluated using questionnaires in both the CD and control groups.
Of the 3792 subjects, 39 were antibody positive (IgA-tTG was positive only in 14 subjects, IgA-tTG plus IgA-EMA in 21 subjects, and IgG-tTG in 4 subjects). IgA deficiency was detected in 11 subjects (0.29%). IgG-tTG was positive in 4 subjects with IgA deficiency (36.3%). Intestinal biopsies were performed on 28 of the 39 seropositive subjects. The biopsy findings of 15 children were consistent with CD (IgA-tTG positive in 3, IgA-tTG and IgA-EMA positive in 10, and IgG-tTG positive in 2). Thus, biopsies confirmed CD in 1:256 children (0.39%).
Our study, which is the first study of school-aged children from the northern region of Cyprus, revealed that CD is a prevalent disease in this region.
KeywordsCeliac disease Children IgA anti-tissue transglutaminase Prevalence
This study was conducted under the leadership and with financial support of the Turkish Pediatric Association. We thank the Cyprus Turkish Pediatric Association, and Turkish Pediatric Association for all their support. We also thank Figen Ince, Hasret Ayyıldız Civan, Mine Ozdil Cirkinoglu, Bircan Kavaz, Hulya Madi, Sevgi Oksuz, Nazife Oner, Kamuran Arıbuka, Saziye Guçlu, Remzi Gardiyanoglu, Nurcin Incirli, Ayten Beyar, Raşit Kayra, Halil Hızal, Hasan Garabli, Cemal Mert, Şenel Dalınç, Nesibe Kocaman, Ayşen Yücel Varol, Cengiz Elyeli, Havva Duran, Pembe Akgöl, Emine Ertekin, Şenay Koşar, Rağbet Tosun, Osman Kılınç, Saniye Yıldırım, Arife Tek, Şengül Uçak, Nevin Çınar, Esma Karaca, Emine Zurnalı, Ayşe Çürük, Hatice Turan, Mahmude Erdevir, Havva Uçar, Suna Sağır, Cemile Şener, and Selçuk Çağsın for both blood sampling in the schools and informing parents of the study group.
Northern Cyprus Celiac Study Group: Adem Karbuz, Serhat Guler, Alper Kacar, Soner Sazak, Figen Ince, Mine Ozdil Cirkinoglu, Bircan Kavaz, Hulya Madi, Sevgi Oksuz, Bekir Yigit Develi, Nazife Oner, Kamuran Arıbuka, Saziye Guçlu, Remzi Gardiyanoglu, Nurcin Incirli.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 7.Pitman M, Sanders DS, Green PHR, Lebwohl B. Rates of Duodenal Biopsy During Upper Endoscopy Differ Widely Between Providers: Implications for Diagnosis of Celiac Disease. J Clin Gastroenterol 2017 Oct 31. https://doi.org/10.1097/mcg.0000000000000957. [Epub ahead of print]. https://www.ncbi.nlm.nih.gov/pubmed/29095420
- 12.World Health Organisation. Physical status: the use and interpretation of anthropometry. In: Report of a WHO Expert Committee. TRS No. 854. Geneva: World Health Organization; 1995.Google Scholar
- 32.Saukkonen J, Kaukinen K, Koivisto AM, et al. Clinical Characteristics and the Dietary Response in Celiac Disease Patients Presenting With or Without Anemia. J Clin Gastroenterol. 2016 Jun 15. [Epub ahead of print]. https://www.ncbi.nlm.nih.gov/pubmed/27306936
- 37.Türkiye Beslenme ve Sağlık Araştırması 2010: Beslenme Durumu ve Alışkanlıklarının Değerlendirilmesi Sonuç Raporu. Ankara: Sağlık Bakanlığı Yayın; 2014;e466-72. Sağlık Bakanlığı Sağlık Araştırmaları Genel Müdürlüğü, Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Beslenme ve Diyetetik Bölümü, Ankara Numune Eğitim ve Araştırma Hastanesi. http://www.sagem.gov.tr/tbsa_beslenme_yayini.pdf