Increased parotid microvascularity without stiffness differences in children with celiac disease

Area of Science:

• Pediatric autoimmune disorders
• Gastroenterology
• Medical imaging

Background:

• Celiac disease is a systemic autoimmune disorder affecting multiple organs, including salivary glands.
• Subclinical parotid gland involvement in pediatric celiac disease remains under-investigated.
• Conventional ultrasound has limitations in detecting early changes in asymptomatic patients.

Purpose of the Study:

• To evaluate subclinical parotid gland involvement in children with celiac disease.
• To assess the utility of microvascular imaging and shear wave elastography (SWE) in detecting early alterations.
• To hypothesize that these advanced imaging tools can identify parenchymal and microcirculatory changes.

Main Methods:

• Prospective, cross-sectional case-control study involving 78 children with celiac disease and 72 healthy controls.
• High-resolution ultrasonography used to assess bilateral parotid microvascularity index (MVI) and tissue stiffness (SWE).
• Radiologist blinded to group allocation; statistical analysis using Mann-Whitney U tests.

Main Results:

• Increased MVI observed in both left and right parotid glands of children with celiac disease compared to controls (P<0.001 and P=0.001, respectively).
• No significant difference in parotid gland tissue stiffness (SWE) between celiac disease patients and controls.
• No significant association found between imaging metrics and serum tTG-IgA levels or modified Marsh grade within the celiac disease group.

Conclusions:

• Pediatric celiac disease is linked to increased parotid gland microvascularity, suggesting subclinical microvascular alterations.
• Shear wave elastography did not reveal significant differences in parotid stiffness.
• Further longitudinal studies are needed to validate these findings and determine clinical relevance.