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Is There a Predictive Factor for an Association with Autoimmune Glandular Disease in Children Diagnosed with Celiac
Fatma İlknur Varol1, Emine Çamtosun2, Mukadder Ayşe Selimoğlu3
1İnönü University Faculty of Medicine, Departments of Pediatric Gastroenterology, Hepatology, and Nutrition, Malatya, Turkey
Insights
Older age at diagnosis is a key predictor for autoimmune glandular disease (AGD) in children with celiac disease (CD). Most AGD diagnoses occurred before CD diagnosis, highlighting age as an important factor.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Immunology
Background:
- Celiac disease (CD) is linked to glandular autoimmunity.
- Identifying predictive factors for autoimmune glandular disease (AGD) in pediatric CD patients is crucial for early intervention.
Purpose of the Study:
- To determine predictive factors for autoimmune glandular disease (AGD) in children diagnosed with celiac disease (CD).
Main Methods:
- Retrospective review of 228 pediatric patients diagnosed with CD between 2010 and 2019.
- Comparison of clinical and laboratory features between pediatric CD patients with and without AGD, and with and without type 1 diabetes mellitus (T1DM).
Main Results:
- Autoimmune glandular disease (AGD) was identified in 8.8% of pediatric CD patients, most commonly type 1 diabetes mellitus (T1DM).
- Patients diagnosed with AGD were significantly older at the time of CD diagnosis compared to those without AGD.
- The majority of AGD diagnoses preceded the celiac disease diagnosis, indicating age as a significant factor.
Conclusions:
- Older age at diagnosis is a significant predictive factor for the coexistence of AGD in children with CD.
- Factors such as gender, celiac symptoms, tissue transglutaminase IgA (TTGA) levels, HLA type, and histopathological stage did not show predictive value for AGD in this cohort.
Objective:
A close relationship has been suggested between Celiac disease (CD) and glandular autoimmunity. The aim of this study was to determine the predictive factors for autoimmune glandular disease (AGD) in children with CD.
Methods:
The study included 228 pediatric patients, diagnosed with CD between 2010 and 2019. The cases with AGD (Group 1) and those without AGD (Group 2) and the patients with type 1 diabetes mellitus (T1DM) (Group A) and those without T1DM (Group B) were retrospectively reviewed and compared in terms of clinical and laboratory features.
Results:
AGD was detected in 8.8% (n=20) of the patients: T1DM in 13 (65%), T1DM and Hashimoto’s thyroiditis (HT) in 3 (15%), HT only in 2 (10%), T1DM and Graves disease (GD) in 1 (5%), and GD only in 1(5%). The mean age at the diagnosis of CD was significantly higher in Group 1 (10.93±4.15 years) compared to Group 2 (8.10±4.19 years) (p<0.05) and also was significantly higher in Group A compared to Group B (p<0.05). Most of the diagnoses of AGD were made before the diagnosis of CD and age was an effective factor. There was no difference between Group 1 and Group 2 and Group A and Group B in terms of gender, typical/atypical CD ratio, tissue transglutaminase IgA (TTGA) level, human leucocyte antigen (HLA)-DQ2 and/or HLA-DQ8 positivity rate, and histopathological stage.
Conclusion:
Although patients with a diagnosis of co-existent CD and AGD were significantly older than patients with isolated CD, gender, celiac symptoms, TTGA level, HLA type, and histopathological stage had no predictive value for the coexistence of AGD in patients with CD.
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