Celiac disease in children with atopic dermatitis

Area of Science:

• Immunology
• Gastroenterology
• Dermatology

Background:

• Celiac disease (CD) is an autoimmune disorder frequently associated with other immune-mediated diseases.
• Atopy, including atopic dermatitis (AD), is often observed in individuals with CD.
• The prevalence of CD in children with AD in Estonia is not well-established.

Purpose of the Study:

• To determine the prevalence of celiac disease (CD) in Estonian children diagnosed with atopic dermatitis (AD).
• To compare the CD prevalence in children with AD to that of the general pediatric population in Estonia.

Main Methods:

• Recruited 351 children with active AD from Tallinn Children's Hospital.
• Tested sera for total IgA, IgA/IgG autoantibodies to tissue transglutaminase (TG2) and deamidated gliadin peptides (DGP).
• Confirmed CD diagnosis histologically via small intestine biopsy according to ESPGHAN criteria.

Main Results:

• Celiac disease was confirmed in 1.4% of children with AD, a rate over four times higher than in the general Estonian child population.
• Two of the five diagnosed patients had silent CD with no indicative symptoms despite significant intestinal changes.
• IgA deficiency was found in 2.6% of patients, with no seropositivity for IgG autoantibodies in this subgroup.

Conclusions:

• The prevalence of CD is significantly higher in Estonian children with AD compared to the general pediatric population.
• Routine screening for CD in children with AD should be considered to enable early diagnosis and prevent long-term complications.
• The study highlights the importance of evaluating the cost-effectiveness of screening AD patients for CD.