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Celiac Disease in Children with Severe Acute Malnutrition (SAM): A Hospital Based Study

Neetu Beniwal1, Gaurav Ameta2, Chandra Kumar Chahar3

  • 1Department of Pediatrics, Geetanjali Medical College, Udaipur, Rajasthan, 313002, India. neetu.beni@gmail.com.

Indian Journal of Pediatrics
|February 9, 2017
PubMed

Insights

Celiac disease is highly prevalent in children with severe acute malnutrition (SAM). Screening for this condition, particularly with symptoms like abdominal distension and pain, is crucial for SAM patient management.

Area of Science:

  • Pediatric Gastroenterology
  • Nutritional Immunology
  • Clinical Diagnostics

Background:

  • Severe acute malnutrition (SAM) is a critical global health issue in children.
  • Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
  • The co-occurrence and clinical presentation of CD in SAM populations require further investigation.

Purpose of the Study:

  • To determine the prevalence of Celiac disease in children diagnosed with severe acute malnutrition.
  • To identify and compare the clinical features of Celiac disease in SAM children versus non-CD SAM children.

Main Methods:

  • A prospective observational study involving SAM children admitted to PBM Children Hospital, Bikaner.
  • Screening for Celiac disease using IgA-anti tissue Transglutaminase (IgA tTG) antibody tests.
  • Confirmation of Celiac disease through upper gastrointestinal endoscopy and small bowel biopsy for seropositive cases.

Main Results:

  • The sero-prevalence of Celiac disease was 15.38%, with a biopsy-confirmed prevalence of 14.42% among SAM children.
  • Abdominal distension and pain were significantly more common in SAM children with Celiac disease.
  • Other symptoms like diarrhea, anorexia, and vitamin deficiencies were also observed more frequently in the CD group.

Conclusions:

  • Celiac disease exhibits a high prevalence within the severe acute malnutrition pediatric population.
  • Routine screening for Celiac disease, especially in SAM children presenting with abdominal distension and pain, is recommended.
  • Integrating CD screening into the diagnostic work-up for SAM can improve patient outcomes.
Abstract

Keywords:
Celiac diseaseIgA-anti tissue transglutaminase antibodiesScreeningSevere acute malnutrition

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