Screening for coeliac disease among Egyptian children

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Genetics

Background:

• Coeliac disease (CD) screening in Egyptian children presenting with non-endocrinal short stature, refractory iron deficiency anemia, and type 1 diabetes.
• Evaluating the diagnostic accuracy of various serological tests for coeliac disease.

Purpose of the Study:

• To determine the prevalence of coeliac disease in Egyptian children with specific clinical risk factors.
• To assess the sensitivity and specificity of different serological markers for coeliac disease diagnosis.

Main Methods:

• Inclusion of 292 pediatric patients with a clinical suspicion of coeliac disease.
• Performance of coeliac antibody testing, upper gastrointestinal endoscopy, and small intestinal biopsy.
• Analysis of diagnostic performance metrics for various antibody tests.

Main Results:

• Coeliac disease was diagnosed in 44% of children with refractory iron deficiency anemia, 34.3% with short stature, and 3% with type 1 diabetes.
• Anti-enteromysial antibody (IgG) demonstrated the highest sensitivity (80.0%), followed by tissue transglutaminase (TTG) (72.7%).
• Anti-reticulin antibody (ARA) exhibited the highest specificity (95.9%), followed by anti-endothelial cell antibodies (anti-EMA) (94.7%).

Conclusions:

• Coeliac disease is more common in Egyptian children with refractory iron deficiency anemia, short stature, and type 1 diabetes than previously recognized.
• Routine screening for coeliac disease in these at-risk pediatric groups is recommended.
• While serological tests offer valuable sensitivity and specificity, intestinal biopsy remains the gold standard for definitive coeliac disease diagnosis.