Prevalence of celiac disease in children with joint hypermobility
Elif Sag1, Ferhat Demir2, Sefa Sag3
1Karadeniz Technical University, Faculty of Medicine, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Trabzon.
Insights
Children with joint hypermobility show a higher prevalence of potential celiac disease. Screening for celiac disease is recommended in hypermobile children with gastrointestinal issues.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Genetics
Background:
- Generalized joint hypermobility involves excessive joint laxity and can be associated with inherited disorders.
- Benign joint hypermobility (BJH) is diagnosed in the absence of systemic rheumatic diseases.
- Recent research indicates a strong link between gastrointestinal disorders and joint hypermobility.
Purpose of the Study:
- To investigate the prevalence of celiac disease in children with joint hypermobility.
- To compare celiac disease rates between hypermobile children and a healthy control group.
Main Methods:
- The study included 131 children with joint hypermobility and 995 healthy children.
- Demographic data, clinical findings, and symptoms were recorded for all participants.
- Celiac disease screening involved serological markers and histopathological examination for positive cases.
Main Results:
- No significant differences were observed in age, gender, malnutrition, or accompanying symptoms between groups.
- Celiac serology positivity and potential celiac disease were significantly higher in the joint hypermobility group (6.2% vs. 0.6%).
- Asymptomatic celiac disease prevalence did not differ significantly between the groups.
Conclusions:
- The study highlights an increased prevalence of potential celiac disease in children with joint hypermobility.
- Serological screening for celiac disease is advised for hypermobile patients presenting with gastrointestinal symptoms.
- This screening aids in ruling out organic gastrointestinal issues in benign joint hypermobility.
Introduction:
Generalized joint hypermobility is a clinical feature that is associated with excessive joint laxity, which can occur alone or with various inherited disorders. The term of benign joint hypermobility or joint hypermobility is used when the presence of musculoskeletal symptoms in subjects with generalized joint hypermobility in the absence of demonstrable systemic rheumatic diseases. In recent studies, it was shown that there is a strong relationship between structural and functional gastrointestinal disorders and joint hypermobility. We aimed to analyze the prevalence of celiac disease in a group patient with joint hypermobility.
Patients And Methods:
The study included the 2 groups of children (i) Group 1; patients with joint hypermobility that were followed in pediatric rheumatology outpatient clinic (n=131). (ii) Group 2; healthy children without known chronic diseases (n=995). Demographic features, clinical findings, accompanying symptoms and anthropometric measurements of all patients were recorded. All cases were screened for celiac disease by serological marker and histopathological examinations if serological marker was positive.
Results:
There was no difference between two groups for age, gender, presence of malnutrition and accompanying symptoms (p>0.05). Serology positivity of anti-tissue transglutaminase IgA >20 RU/ml was found in seven patients with joint hypermobility. After histopathological examinations, asymptomatic celiac disease was detected in one (n=1, 0.9%) and potential celiac disease in six patients (n=6, 5.3%). There were six (0.6%) patients with positive serology in the control group. Celiac serology positivity and potential celiac disease were higher in patients with joint hypermobility (6.2%, vs. 0.6%, OR: 10.9, 95% CI: 3.6-33, p < 0.001 and 5.3%, vs. 0.4%, OR: 13.9, 95% CI: 3.6-50, p < 0.001, respectively), but no significant difference was found on the prevalence of asymptomatic celiac disease (0.9%, vs. 0.2%, OR: 4.4, p=0.22).
Conclusion:
Our study shows the increased prevalence of potential celiac disease in patients with joint hypermobility. Serological screening of celiac disease is recommended for to rule out organic problems in the presence gastrointestinal symptoms in patients with BJH.
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