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Evaluation of Frequency of Celiac Disease in Children with Idiopathic Epilepsy
Roohollah Edalatkhah1, Majid Aflatooninan1, Bahareh Dehghani Firouzabadi1
1Pediatric Gastroentrologist, Assistant Professor, Department of Pediatrics, Children Growth Disorder Research Center, School of Medicine, Shahid Sadoughi General Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Insights
Celiac disease (CD) may be linked to epilepsy in children. This study found 7.5% of children with idiopathic epilepsy had CD, suggesting neurological symptoms warrant celiac screening.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Immunology
Background:
- Extra-intestinal manifestations, including neurological symptoms, are increasingly recognized in pediatric celiac disease (CD).
- Idiopathic epilepsy in children may present with or be associated with underlying conditions.
- Evaluating the prevalence of CD in children with idiopathic epilepsy is crucial for diagnosis and management.
Purpose of the Study:
- To determine the frequency of celiac disease (CD) in a pediatric cohort presenting with idiopathic epilepsy.
- To investigate the association between celiac disease and the age of seizure onset in children.
Main Methods:
- A cross-sectional study involving 40 children (aged 2-14 years) with idiopathic epilepsy.
- Assessment of celiac disease (CD) included serum testing for tissue transglutaminase antibody (tTG) and total IgA.
- Upper gastrointestinal endoscopy with small intestine biopsy was performed for patients with abnormal serological markers.
Main Results:
- Only 7.5% (3 out of 40) of children with epilepsy exhibited abnormal tTG and IgA levels.
- Duodenal biopsies confirmed total villous atrophy (Marsh type 3) in these three children, indicating celiac disease.
- Children diagnosed with CD had a later age of seizure onset ( > 3 years) compared to those without CD ( < 3 years).
Conclusions:
- Celiac disease is associated with idiopathic epilepsy in children.
- The age of seizure onset may differ between children with and without celiac disease.
- Pediatric patients presenting with neurological symptoms, particularly epilepsy, should be screened for celiac disease.
Objectives:
Extra gastrointestinal symptoms in celiac disease (CD), such as neurological manifestations, might be common in pediatrics. The present study aimed to evaluate the frequency of CD in children with idiopathic epilepsy.
Materials & Methods:
In a cross-sectional study, signs and symptoms of CD were evaluated in 40 children aged 2-14 years with idiopathic epilepsy who were referred to the Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran. Then, serum levels of tissue transglutaminase antibody (tTG) and total IgA were measured in them. Upper gastrointestinal endoscopy and small intestine biopsy were recommended for patients with abnormal serum IgA Anti-tTG.
Results:
Eighteen girls and 22 boys with a mean age of 5.29±2.4 years were evaluated. In this study, only three patients (7.5%) with epilepsy had abnormal serum IgA Anti-tTG and serum Total IgA. Upper gastrointestinal endoscopy and pathological examination of duodenal biopsy of those three children reported total villous atrophy (Marsh type 3). The age of onset of seizures in children with CD was more than three years, while in children without CD, 62.2% of cases were less than three years. These results indicate that CD is associated with the age of onset of seizures in children.
Conclusion:
Due to the accompaniment of celiac with neurological manifestations, patients with neurological symptoms and gastrointestinal symptoms should be examined for celiac.
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