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Introduction: Celiac Disease shares clinical features with malnutrition and may be responsible for malnutrition. The objective of this study was to study clinico-laboratory profile of seropositive Celiac Diseases in Severe Acute Malnutrition. Material & Methods: The present study was a prospective, hospital based, observational study conducted at Malnutrition Treatment Centre (MTC) of tertiary care Pediatric hospital associated with government medical college of southern Rajasthan. The study was conducted over the period of one year from Dec. 2017 to Nov. 2018. Total 110 children with Severe Acute Malnutrition enrolled and screened for Celiac Disease on the basis of celiac serology (tTg-IgA/IgG). Clinico-laboratory findings of celiac seropositive and seronegative patients were recorded and analysed statistically. Results: Celiacsero-positivity was observed in 30 cases (27.28%). Out of these seropositive cases 14 cases (46.66%) were seropositive for both tTg-IgA and IgG, while 9 cases (30%) were positive for only tTg-IgA and rest 7 cases (23.33%) were positive for only tTg-IgG. Most of the seropositive patients (12, 40%) were in age group of 4-5 years of age group. In seropositive cases recurrent blood in stool (54.45%) and recurrent diarrhoea (52.94%) were common clinical features at the time of admission. S. Vit. B12 & Folic Acid were low in all the patients but more seropositive patients showed low levels of S. Folic acid (P value

Introduction: The aim of the study was to assess the prevalence of Helicobacter pylori (HP) in children with celiac disease (CD) and its relationship with clinical, histopathological, and laboratory parameters. Material and methods: Two hundred and fifty-six patients with serologically and histopathologically diagnosed CD at the Pediatric Gastroenterology Department, Turkey, from January 2012 to March 2017, were included in the study, as well as 1012 patients with dyspeptic complaints. Biopsies of the duodenum and antrum were taken; the existence of HP and the histological level of damage were studied. HP (+) and HP (-) cases were compared according to age, sex, noted complaints, and clinical and laboratory features. Results: Seventy (27.4%) CD patients and 270 (26.7%) patients with dyspeptic complaints were HP (+). The diagnostic age was higher in HP (+) cases, and diarrhea and abdominal distension were significantly higher. Although hemoglobin, ferritin, vitamin B12, and transferrin saturation were lower in HP (+) cases, the differences were not statistically significant. The serum folate level in the HP (+) group was significantly lower compared to the HP (-) group. Conclusions: The prevalence of HP was not increased in cases of CD. The CD was diagnosed later in HP (+) cases, distension and diarrhea complaints were more frequent, and folate deficiency was significant. © 2019 Termedia & Banach.

In this current scenario with changing food habits, escalating population and unrestricted use of natural resources, there are lacking of resources to provide nutritious food to all. Natural plant resources are fast depleting and need to explore new alternatives. Besides the staple rice and wheat; lots of underutilized crops are being consumed that are having great potential to replace the staple crops. Millets are one of the major underutilized crops with a Nutri-cereal potential. Millets are highly nutritive, non-acid-forming, gluten-free and having dietary properties. Despite the fact that millets are highly nutritious, their consumption is still limited to the conventional and poor population due to lack of awareness towards its nutritional values. There is lack of processing technologies, lack of food subsidies and inconvenience in food preparations which makes millets more obsolete. Millets are Nutri-cereals and rich in carbohydrates, dietary fibres, energy, essential fatty acids, proteins, vitamin-B and minerals such as calcium, iron, magnesium, potassium and zinc, which helps to prevent from post-translational diseases like, diabetes, cancer, cardiovascular and celiac diseases, etc. Millets help in controlling blood pressure, blood sugar level and thyroid but inspite of these functional properties, millets consumption is still declining. Millets utilization in-combination with other staple food crops to develop food alternatives has become an emerging area for food industries. Besides, to strengthen our fight against malnutrition in children and adolescents, consumption of millets can help to foster immunity and health. Here, author’s have reviewed the potential of millets for their Nutri-cereal qualities.

A lifelong adherence to a gluten-free (GF) diet is currently the only treatment for Celiac disease (CD), an autoimmune disorder that arises after gluten ingestion in individuals who are genetically predisposed. The gluten intake exerts toxic effects through several pathways involving gut barrier integrity, intestinal microbiota composition and immune system stimulation. However, despite the great benefit of GF diet for CD patients, its use has been debated. Indeed, individuals who adopt this diet regime may be at risk of nutrient deficiencies. Emerging evidence supports a beneficial effect of a GF diet also for other pathological conditions, including gluten-related disorders (GRD) often associated to CD, such as Non celiac gluten sensitivity (NCGS) and Dermatitis Herpetiforme (DH) as well as Irritable bowel syndrome (IBS) and Diabetes. This suggests a pathogenic role of gluten in these conditions. Despite the growing popularity of GF diet among consumers, to date, there are limited evidences supporting its use for the management of non-celiac diseases. Therefore, in this review, we discuss whether the GF diet could really improve the general quality of life of patients with GRD and non-GRD conditions, keeping in mind its sensorial limitations and nutritional inadequacies. In addition, we discuss the current motivations, leading to the use of a GF diet, despite the inferior quality of GF products respect to those containing gluten.

Introduction: Celiac disease (CD) may be an underlying cause of malnutrition. Aim: The objective of this study was to find out the seroprevalence of CD in children suffering from severe acute malnutrition (SAM) in age group of 1–5 years. Materials and Methods: This was a prospective, observational, hospital-based study carried out at Malnutrition Treatment Centre attached with tertiary care pediatric hospital associated with the medical college of southern Rajasthan, from December 2017 to November 2018. A total of 110 children with SAM were enrolled and screened for CD on the basis of celiac serology (tissuetransglutaminase [tTg]-immunoglobulin A/G [IgA/IgG]). Results: Celiac serology was positivity in 30 (27.28%) cases; out of total 30 seropositive cases, 14 (46.66%) cases were seropositive for both tTg-IgA and IgG, while only tTg-IgA and only tTg-IgG were positive in 9 (30%) and 7 (23.33%) cases, respectively. Mean serotiter of serum tTg-IgA and IgG in seropositive cases was 134.01±198.74 and 49.05±25.74 unit/ml. Conclusions: High seroprevalence of CD in SAM should be taken as alert as CD may be an underlying cause and responsible for malnutrition. These children should be screened by celiac serology (tTg-IgA/IgG) to rule out CD.

Background Crohn disease (CD), environmental enteric dysfunction (EED) and celiac disease are prevalent enteropathies linked to chronic gut inflammation. However, unlike celiac and Crohn that are prevalent in westernized countries, EED is seen in only in low- and middle-income countries of the developing world. Recent work has defined specific EED duodenal microbiota associated with stunting, and transmission of EED histologic changes and weight loss by microbial transfer to germ free mice. Methods We performed high throughput transcriptomics of 94 duodenal samples from the SEEM cohort:52 undernourished EED participants, 17 celiac and 25 healthy North American controls. We compared those to our previously reported transcriptomics of 248 newly diagnosed ileal CD from RISK. Comparison were performed between cases and controls within each cohort. Results Above 90% of the expressed protein coding genes are shared between duodenum samples within SEEM, and Crohn ileal within RISK enabling the anticipated comparison. A substantial number of the down-regulated genes in undernourished EED participants overlapped with celiac (212/481, 44%) and with Crohn Disease (249/481, 52%). Shared reduced signatures and functions included decrease in epithelial lipid metabolism, vitamins, and brush border transport signatures. Relative to celiac disease, suppression of antioxidant and detoxification genes were EED- and Crohn-specific, which include the reduction of metallothioneins (MT family) that buffer against toxic metals, and aldo-keto NADPH- genes (AKR1C family) involved in detoxification of environmental compounds. A smaller proportion of the EED up-regulated signal overlapped with celiac (85/781), and we noted a more significant overlap with Crohn disease (248/781, Chi squares p Conclusion We highlight important biologic signals widely overlapping between Crohn Disease (CD) and EED transcriptome in the small intestine, suggesting mechanisms involving altered gut microbiota. Inhibiting innate immune activation or reverting Crohn dysbiosis may be beneficial future therapy for Crohn Disease and EED.

Objectives. The current European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines introduced the option to diagnose coeliac disease (CD) in children and adolescents without upper endoscopy if the defined criteria are met. The aim of our study was to evaluate how frequently paediatric gastroenterologists in Central Europe used the “no-biopsy” approach and how often the duodenal biopsy could have been omitted. Methods. Medical records of patients aged<19 years diagnosed with CD in 2016 from five European countries were analysed, focusing on levels of transglutaminase antibodies (TGA) at the time of diagnosis and on whether the diagnosis was confirmed using duodenal biopsy or “no-biopsy” approach. Clinical presentation and delays until final diagnosis were analysed according to diagnostic approach. Results. Data from 653 children (63.9% female, median age: 7 years, range: 7 months-18.5 years) from Croatia, Hungary, Germany, Italy, and Slovenia were analysed. One fifth (n=134) of included children were asymptomatic at diagnosis. Of 519 symptomatic children, 107 (20.6%) were diagnosed by the “no-biopsy” approach. Out of the remaining 412 children who underwent duodenal biopsies, 214 (51.9%) had TGA≥10 times upper level of normal (ULN) and would have been eligible for the “no-biopsy” approach. Signs and symptoms of malabsorption were more frequent in children diagnosed without duodenal biopsies. There were no differences in diagnostic delays with respect to the diagnostic approach. Conclusion. In this cohort, about 60% of symptomatic CD patients could have been diagnosed without duodenal biopsies. The aim of the “no-biopsy” approach was to make the diagnostic procedure less challenging without compromising its reliability. However, this option was applied only in 20%, in spite of fewer burdens to the family and reduced costs. The reasons for this discrepancy are unknown. Physicians should be made more aware about the reliability of CD diagnosis without biopsies when the ESPGHAN guidelines for CD diagnosis are followed.

Intestinal alkaline phosphatase enzyme plays a pivotal role in the maintenance of intestinal mucosal barrier integrity with the detoxification capacity of lipopolysaccharide, the ligand of Toll-like receptor 4. The inappropriate immune responses and the damage of the mucosal barrier may contribute to the initiation of inflammatory bowel and celiac diseases. In the inflamed colonic mucosa of children with inflammatory bowel disease and in the duodenal mucosa of newly diagnosed children with celiac disease, the decreased intestinal alkaline phosphatase and increased Toll-like receptor 4 protein expression may generate enhanced lipopolysaccharide activity, which may strengthen tissue damaging processes. The enhancement of intestinal alkaline phosphatase activity in an animal model of colitis and in therapy resistant, adult patients with ulcerative colitis reduced the symptoms of intestinal inflammation. In accordance with these results, the targeted intestinal administration of the enzyme in the two examined disorders may be a supplemental therapeutic option in the future. Orv. Hetil., 2012, 153, 1389–1395.

In order to provide better therapy we strive to increase our knowledge of how the immune system behaves and communicates in common pediatric immunological diseases, such as type 1 diabetes, allergic and celiac diseases. However, when dealing with pediatric diseases, where study subjects are almost exclusively children, blood volumes available for immunological studies are limited and as such must be carefully handled and used to their full extent. Single immune markers can easily be detected by a traditional Enzyme Linked Immunosorbent Assay (ELISA), whereas multiple markers can be detected by a fluorochrome (Luminex) or electrochemiluminescence (MSD) technique. These techniques however are sometimes not sensitive enough to detect low levels of secreted immune markers in limited sample sizes. To detect immune markers at the single-cell level, an Enzyme Linked Immuno-spot (ELISPOT) can be used to pin-point elusive immune markers in common pediatric immunological diseases.

Dual X-ray absorptiometry is the common technique to determine bone mineral density. Because of high costs and limited availability, it is worthwhile to look for alternative diagnostic techniques. The objective of this study was to investigate the use of panoramic radiographs measurements as a predictor for bone mineral density and to identify the subjects with osteoporosis and the increased risk of osteoporotic fractures in celiac patients. The sample of this study consisted of 60 celiac patients (36 males and 24 females) aged 22 to 46 years. All patients were diagnosed with celiac diseases, according to criteria of European Society of Gastroenterology. bone mineral density values were measured by Dual X- ray absorptiometry equipment at the lumbar spine and were categorized according to World Health Organization classification. Panoramic radiographs were obtained at the same time for all celiac patients providing two essential measurements; mental index and panoramic index. It was found that the mental index and panoramic index measurements were significantly related to bone mineral density measured by Dual X-ray absorptiometry and therefore could be used as diagnostic indicators of mandibular bone mineral density and play a significant role in celiac patient screening for osteoporosis.

Celiac disease (CD) affects people in all parts of the world. In last decades celiac disease thought to be a rare childhood syndrome, but currently is celiac disease known to be a common autoimmune genetic disorder [1]. More than 2 million people in the United States have the disease, or about 1 in 133 people [2]. Among people who have a first-degree relative (parent, sibling, or child) diagnosed with celiac disease, as many as 1 in 22 people may have the disease [2,3].