Search

Measurement of anti-TTG, liver manifestation, and BMI in Iraqi patients with celiac disease (CD) with and without a gluten-free diet (GFD) in order to validate their role in the exacerbation of CD symptoms. The study was carried out on CD patients with a duration of disease ranging from 1 to 10 years (n = 52, age range: 20- 55). The patients’ group was subdivided into the PI group (n = 29), which includes patients with GFD, and the PII group (n = 23), which includes patients without GFD. The studied groups were matched with 51 healthy individuals as the control group (C) (age range: 20-55). The results obtained from the present study indicate a highly significant increase (P = 0.000) in serum anti-TTG in the PI and PII groups as compared with the C group. BMI values showed a highly significant decrease (P = 0.007) in the PI and PII groups as compared with the C group. The activity of GGT, ALT, AST, and GOT/GPT ratio showed no significant difference in the P, PI, and PII groups as compared with the C group, while a highly significant increase in GGT was noticed upon the comparison of PI with PII (P = 0.004). It was concluded from the current study that high levels of TTG are associated with CD patients regardless of adherence to the GFD or not, while the high activity of GGT is associated with long-term adherence to the GFD. [ABSTRACT FROM AUTHOR]

Coeliac Disease (CD) and Sjogren’s Syndrome (SS), both autoimmune disorders, are gaining attention for their complex interaction when occurring together. CD involves gluten intolerance and can present with gastrointestinal symptoms, while SS affects various organs, primarily causing dryness of the eyes and mouth. Diagnosis for each relies on specific criteria including serologic testing and histopathology. When these conditions overlap, they create unique clinical challenges, highlighting the need for a thorough understanding of their combined effects on health. This exploration aimed to uncover the intricacies of their relationship, including clinical manifestations and implications for diagnosis and management when dealing with both simultaneously. In both cases (58-year-old female and 47-year-old female), there was gastrointestinal villous atrophy as a manifestation of CD, which improved with simple dietary modification.

Several possible associations between different types of autoimmune diseases have been reported, therefore this study aimed to investigate the relationship between celiac disease (CD) and some related autoimmune diseases by determining the effect of gluten on severity of these diseases. Two hundred blood samples were collected, 50 samples were withdrawn from healthy donors as a control group, 75 were collected from newly diagnosed (ND) CD patients, while the remaining blood samples (75) were obtained from the same patients after 4 months of gluten free diet (GFD) regime. Sera were separated to measure the level of anti-tissue transglutaminase IgA (tTG-IgA), anti-pituitary IgG, anti- thyroid peroxidase IgG (TPO- IgG), anti-islet IgG and anti-ganglioside IgG (IU/ml) by enzyme linked immunosorbent assay (ELISA). To analyze the results and compare between groups, GraphPad Prism was utilized. The results recorded high significant elevation (p>0.0001) in the concentrations of all autoantibodies of both ND and GFD groups compared with their concentrations in the control group. Furthermore, after 4 months of GFD, all autoantibodies concentrations revealed highly significant decreases (p>0.0001) as compared with ND. Regarding the correlation of all studied autoantibodies with anti tTG-IgA, only anti-ganglioside IgG levels were weakly correlated in pre-GFD treatment patients, meanwhile anti-ganglioside IgG and anti-pituitary IgG were also recorded weak correlations in post- GFD of CD patients. This study concluded that GFD helps to reduce the severity of endocrine and neuron autoimmune disorders in addition to CD, which have been proved by decreasing in the level of their diagnostic autoantibodies. [ J Adv Biotechnol Exp Ther 2024; 7(1.000): 34-43]

Coeliac Disease (CD) and Sjogren's Syndrome (SS), both autoimmune disorders, are gaining attention for their complex interaction when occurring together. CD involves gluten intolerance and can present with gastrointestinal symptoms, while SS affects various organs, primarily causing dryness of the eyes and mouth. Diagnosis for each relies on specific criteria including serologic testing and histopathology. When these conditions overlap, they create unique clinical challenges, highlighting the need for a thorough understanding of their combined effects on health. This exploration aimed to uncover the intricacies of their relationship, including clinical manifestations and implications for diagnosis and management when dealing with both simultaneously. In both cases (58-year-old female and 47-year-old female), there was gastrointestinal villous atrophy as a manifestation of CD, which improved with simple dietary modification. [ABSTRACT FROM AUTHOR]

Abstract Background Celiac disease (CD) is characterized by elevated serum titers of autoantibodies IgA anti-tissue transglutaminase 2 (TGA-IgA) and IgA anti-endomysial (EMA), with small bowel mucosa atrophy. We evaluated age differences between CD children exhibiting variable antibody titers at diagnosis. Methods CD children diagnosed between January 2014 and June 2019, according to 2012 ESPGHAN guidelines were studied. All had EMA and TGA-IgA measurements, while a proportion of them underwent esophagogastroduodenoscopy (EGD). Patients were grouped based on serum TGA-IgA titers normalized to the upper limit of normal (ULN) and differences in median age (years) assessed by analysis of variance (ANOVA) and creation of orthogonal contrasts. Results CD was diagnosed in 295 subjects (median age: 4.4 [IQR: 2.60–8.52]) with a biopsy sparing protocol (high titer: ≥ 10xULN) and in 204 by EGD biopsy. Of the latter, 142 (median age: 8.5 [IQR: 5.81–11.06]) and 62 (median age: 9.5 [IQR: 6.26–12.76]) had a low (

Abstract Background Evidence shows the increase of anti-tissue transglutaminase (tTG) levels in various conditions, including infectious agents, independently of celiac disease (CD). The aim of this study was to investigate the effect of helicobacter pylori (H.pylori) infection eradication on serum level of tTG in children with CD. Methods This study was conducted on children aged 2 to 18 who referred to reference hospitals for diagnosis of CD. After upper endoscopy and biopsy to confirm CD and H.pylori infection, the children were divided into three groups (including group one: 16 CD patients with positive H. pylori; group two: 16 non-CD patients with positive H. pylori; and group three: 56 CD patients with negative H. pylori), respectively. The tTG level in study groups were compared after the eradication of H.pylori. Results The mean age of the subjects in the group one, two, and three was 9.7 ± 3.33, 11.8 ± 3.14, and 7.6 ± 3.32 years, respectively. Our results showed that in group one, mean tTG increased after eradication of H.pylori infection, however, these changes were not significant (182.43 vs. 157.18, P = 0.121). In the second group, although unlike the first group, mean tTG decreased after eradication of the infection, but still these changes were not significant (9.56 vs. 22.18, P = 0.449). Furthermore, at the baseline level, the mean tTG in the group three was closer to the mean tTG in the first group. Conclusion Our findings showed that the eradication of H.pylori infection does not have a significant effect on tTG levels in children with and without CD.

Background: Celiac disease (CD) is characterized by elevated serum titers of autoantibodies IgA anti-tissue transglutaminase 2 (TGA-IgA) and IgA anti-endomysial (EMA), with small bowel mucosa atrophy. We evaluated age differences between CD children exhibiting variable antibody titers at diagnosis. Methods: CD children diagnosed between January 2014 and June 2019, according to 2012 ESPGHAN guidelines were studied. All had EMA and TGA-IgA measurements, while a proportion of them underwent esophagogastroduodenoscopy (EGD). Patients were grouped based on serum TGA-IgA titers normalized to the upper limit of normal (ULN) and differences in median age (years) assessed by analysis of variance (ANOVA) and creation of orthogonal contrasts. Results: CD was diagnosed in 295 subjects (median age: 4.4 [IQR: 2.60–8.52]) with a biopsy sparing protocol (high titer: ≥ 10xULN) and in 204 by EGD biopsy. Of the latter, 142 (median age: 8.5 [IQR: 5.81–11.06]) and 62 (median age: 9.5 [IQR: 6.26–12.76]) had a low (< 5xULN) and a moderate (≥ 5 < 10xULN) TGA-IgA titer, respectively. Potential CD was diagnosed in 20 patients (median age: 3.6 [IQR: 2.47–6.91]). The median age was significantly lower in the no-biopsy group (ANOVA: F(3, 516) = 25.98, p <.001) than in low- and moderate titer groups (p < 0.0001), while there was no statistical difference between biopsy-sparing and potential CD groups. Conclusion: CD patients with greatly elevated antibody titers (≥ 10xULN) were diagnosed at an earlier age than those with lower titers. This may indicate that an increase in TGA-IgA is independent of age and suggests a polarization of autoimmunity in younger individuals with higher serum antibody levels. [ABSTRACT FROM AUTHOR]

Background: Evidence shows the increase of anti-tissue transglutaminase (tTG) levels in various conditions, including infectious agents, independently of celiac disease (CD). The aim of this study was to investigate the effect of helicobacter pylori (H.pylori) infection eradication on serum level of tTG in children with CD. Methods: This study was conducted on children aged 2 to 18 who referred to reference hospitals for diagnosis of CD. After upper endoscopy and biopsy to confirm CD and H.pylori infection, the children were divided into three groups (including group one: 16 CD patients with positive H. pylori; group two: 16 non-CD patients with positive H. pylori; and group three: 56 CD patients with negative H. pylori), respectively. The tTG level in study groups were compared after the eradication of H.pylori. Results: The mean age of the subjects in the group one, two, and three was 9.7 ± 3.33, 11.8 ± 3.14, and 7.6 ± 3.32 years, respectively. Our results showed that in group one, mean tTG increased after eradication of H.pylori infection, however, these changes were not significant (182.43 vs. 157.18, P = 0.121). In the second group, although unlike the first group, mean tTG decreased after eradication of the infection, but still these changes were not significant (9.56 vs. 22.18, P = 0.449). Furthermore, at the baseline level, the mean tTG in the group three was closer to the mean tTG in the first group. Conclusion: Our findings showed that the eradication of H.pylori infection does not have a significant effect on tTG levels in children with and without CD. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is an autoimmune disorder resulting from the destruction of melanocytes of affected patients. Celiac disease (CD) is characterised by autoimmune inflammation of small intestinal mucosa specifically triggered by the gluten consumption in susceptible individuals. Immunoglobulin A (IgA) anti-tissue transglutaminase (anti-tTG) serology is recommended as an initial test for the diagnosis of CD prior to confirmation with intestinal biopsy. Aim: We aimed to compare the serum IgA anti-tTG levels in vitiligo patients and controls without vitiligo in a hospital in South-West Nigeria. Materials and Methods: The study was a case–control study of 33 vitiligo cases and 33 controls. IgA anti-tTG was assayed in participants' sera using an enzyme-linked immunosorbent assay protocol employing recombinant human tTG. Results: A total of 66 participants were recruited into the study; 33 cases with vitiligo and 33 controls. The median age for cases was 50 years (range: 4–82). The median age for the controls was 55 years (range: 23–76). Generalised vitiligo accounted for 13 (40%) of vitiligo cases with the others consisting of various forms of segmental vitiligo. Anti-tTG levels were higher in cases at 6.1U/ml (8.8, 0.6–20.0) (med [interquartile range (IQR), min-max]), compared to controls 5.2 U/ml (3.7, 0.7–22.4). Difference between groups estimated using the Mann-Whitney U-test was not significant, u = 408.0, P = 0.08 (α = 0.05). Conclusion: There was no significant difference in serum IgA anti-tTG in vitiligo cases and controls in this study. Further studies are required to clarify the nature of the association between vitiligo and CD.

Background and Aims: Inflammatory cytokines levels may be elevated in patients with celiac disease (CD). But little known about the association of these cytokines and some immunological parameters used for diagnosis of celiac disease. This study aimed to evaluate the levels of some inflammatory cytokines in patients with celiac disease and compare it with healthy individuals and then their association with some immunological markers used for diagnosis of celiac disease. Methods: A total of 60 patients with celiac disease and 40 healthy persons were enrolled in 2019. The levels of Anti-tissue transglutaminase levels were measured for patients and healthy groups, also Tumor necrosis factor Alpha (TNF-α), Interleukin-6 (IL-6) and Interleukin-8 (IL-8) were measured using enzyme-linked immunosorbent assay techniques. Then compare these parameters between groups and the correlation between these parameters were assessed. Results: The mean levels of Tumor necrosis factor Alpha (TNF-α), Interleukin-6 (IL-6) and Interleukin-8 (IL-8) give a highly significant difference between patients and healthy groups. Anti-tissue transglutaminase levels correlated and were show statistically significant with these cytokines. Conclusions: TNF-α, IL-6 and IL-8 play a role in the pathophysiology of celiac disease. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an immune-mediated enteropathy triggered by dietary ingestion of gluten in genetically susceptible patients. CD is often diagnosed by a "case-finding" approach of symptomatic patients. In recent times, the diagnostic paradigm has shifted to investigate patients who may be asymptomatic, but are at high risk of developing CD due to shared genetic susceptibilities. These high-risk groups include first-degree relatives of CD patients and patients with Type 1 diabetes mellitus, autoimmune thyroid disease, Down's syndrome, and Turner syndrome. Moreover, CD is often diagnosed as the cause of iron deficiency anemia or unexplained chronic diarrhea. Although screening for CD with serological tests is not recommended for the general population, it should be considered in these special populations. In this review, we explore screening for CD among high-risk groups in light of recent research and development in the CD arena. [ABSTRACT FROM AUTHOR]

Purpose: Synbiotics can alleviate some intestinal pathologies or prevent trigger mechanisms for some diseases such as celiac disease (CD). If patients with high levels of anti-tissue transglutaminase (anti-tTG) immunoglobulin A (IgA) antibodies have normal duodenal histology, they are followed as potential CD patients. The aim of this study was to investigate the effect of synbiotic use on the blood levels of anti-tTG antibodies in children. Methods: Eighty-two patients with high anti-tTG levels were included in this study. Patients were randomly divided into two groups. The synbiotic group was treated with a daily dose of a synbiotic including multi-strain probiotics for 20 days. The control group was not administered any medication. Anti-tTG values at baseline and repeat measurements and the percentage change in anti-tTG levels between groups were compared. Results: The anti-tTG level at baseline was 36 U/mL (interquartile range [IQR], 26.4-68 U/ mL) in the synbiotic group, and it decreased significantly to 13 U/mL (IQR, 6.5-27.5 U/mL) after 20 days ( p<0.05). The anti-tTG level at baseline was 46 U/mL (IQR, 31-89 U/mL) in the control group, which also decreased significantly to 23 U/mL (IQR, 7-41 U/mL) after 20 days ( p<0.05). Anti-tTG levels exhibited 73% and 56% decreases in the synbiotic and control groups, respectively ( p<0.05). Conclusion: It may be speculated that a synbiotic supplementation can contribute to decreasing anti-tTG levels in children with potential CD. [ABSTRACT FROM AUTHOR]

Introduction & Aim: Anti-tissue transglutaminase antibody (tTGA) titer is used during the follow-up of celiac patients to evaluate gluten-free diet (GFD) responsiveness. However, no clear data are available on this issue. The aim of this study was to evaluate tTGA significance during celiac disease (CD) monitoring. Methods: From January 2017 to January 2020, consecutive CD patients on a GFD with persistent positive tTGA were enrolled. Antibody titres were evaluated on a yearly basis from CD diagnosis to the last follow-up. Urinary gluten detection tests, duodenal histology and capsule enteroscopy (CE) were performed. A tTGA-positive cohort was compared with a control group composed of 212 treated CD patients with negative tTGA. Results: 65 patients (12% males, median age at enrollment and CD diagnosis, 37 (14–86) and 31 (1–76), respectively, median follow up 4 (1–26) years) presented with positive tTGA during follow-up. Overall, the tTGA titres were 3 (1–79) fold increased (ULN). Three different tTGA trends were recognized: (I) 36 (55%) patients with a progressive titres decrease; (II) 16 (25%) patients with a fluctuating behavior; (III) 13 (20%) patients with a steady state or increased titres. tTGA+ patients did not present with different clinical and demographic parameters. Duodenal atrophy was present in 10% vs. 36% of the tTGA positive vs. negative group (p < 0.005), respectively. Gluten detection results were positive in 3 (8%) cases, all in the III group. In tTGA+ patients, CE did not identify any CD-related complications. Conclusions: tTGA positivity during CD follow up did not present a relevant clinical significance without association with autoimmune comorbidities and mucosal damage.

Celiac disease is a human leukocyte antigen-DQ2 (or DQ8) associated autoimmune disorder of the smallintestine induced by dietary exposure to wheat gliadin, barley hordein, rye secalin and possibly oat avenis.It is characterized by mucosal damage, loss of absorptive villi and hyperplasia of the crypts leading tomalabsorption. In addition, to nutrient deficiencies and growth failure, prolonged untreated celiac disease isassociated with an increased risk of malignancy, especially intestinal T cell lymphoma. Tissue transglutaminaseantibody tTG antibodies of isotype IgA and IgG is a simple, sensitive and specific noninvasive screening testfor diagnosis of celiac disease, particularly in developing countries like Pakistan. In current study fromSeptember 2010 to May 2014, samples from 3643 cases referred to Dow Diagnostic Research and Referencelab were screened for serum IgA and IgG for tissue transglutaminase by ELISA. Results showed that about1290 patients were anti TtG IgA positive including male and female with a ratio of 1:1.4 respectively, indicatingan active stage of the disease. Children (age group between 0 to 16) showed a greater prevalence i.e 37% ascompared to other age group. However IgG against tissue transglutaminase didn’t show any significantprevalence pattern.

Background: The clinical, histological, and serological spectrum of celiac disease (CD) vary widely. We aimed to examine relationships between symptoms, serum anti-tissue transglutaminase antibodies (tTG) levels, mucosal damage, and mucosal anti-tTG deposits in pediatric CD. Methods: A retrospective single-center, cohort study of children referred for endoscopy with suspected CD during 2011–2014. We retrieved the clinical data, blindly reviewed duodenal biopsies, and performed immunohistochemical staining for anti-tTG deposits. Patients were classified as monosymptomatic or polysymptomatic. Mucosal anti-tTG deposits were classified according to the location of deposits, dominant intensity, maximal intensity, and percentage of stained area. Results: Of 252 patients with confirmed CD, complete data were available for 100: 37 males in the age range 1.3–16.7 with median 4.0 years. Monosymptomatic patients (n = 54) presented at an older age than polysymptomatic patients (1.3–15.5, median 8.1 vs. 1.3–16.7, median 6.3 years, p = 0.026). Marsh 2–3c was more prevalent in polysymptomatic patients (93 vs. 78%, p = 0.028). The intensity of mucosal anti-tTG deposits correlated with serum anti-tTG levels but not with the clinical presentation. Conclusions: Multiple symptoms and high serum anti-tTG antibody levels correlated with mucosal damage in children with CD. The role of immunohistochemical staining for intestinal anti-tTG mucosal deposits in the diagnosis of borderline CD is not yet established. [ABSTRACT FROM AUTHOR]

Celiac disease is a common autoimmune disorder of the small intestine, triggered by an immunological response to the gluten present in wheat, barley, and rye in individuals who are genetically at risk. A key to reducing the complications of this disease is early diagnosis, preferably in childhood, and consuming a lifelong gluten-free diet once diagnosis is confirmed. Yet, the diagnosis of celiac disease is often considerably delayed, exposing patients to needless suffering and morbidity. It is also difficult to confirm histologically if dietary gluten has been restricted prior to obtaining a diagnostic biopsy, a significant problem given the current growing popularity of gluten-free diets. Furthermore, failure to understand or follow current guidelines means physicians may recommend patients commence the gluten-free diet before initiating referral to a gastroenterologist. Finally, adding further confusion, pediatric guidelines in Europe support a diagnosis based on serology rather than on histology, whereas those based in North America do not. The purpose of this review is to discuss these issues and other controversies in the diagnosis of celiac disease and to consider ways to optimize diagnosis across the lifespan. [ABSTRACT FROM AUTHOR]

A GQD/PAMAM nanohybrid modified on gold nanoparticles (AuNP) embedded in multiwalled carbon nanotubes (MWCNT) based immunosensor was developed for detection of celiac disease in human. The AuNP embedded in MWCNT were linked with thiol groups of cysteine and amino groups were further coupled with carboxyl moieties of graphene quantum dots (GQDs) using EDC-NHS cross-linking chemistry. To enhance the sensitivity of the sensor, polyamidoamine (PAMAM) dendrimer was attached with GQDs through carbodiimide coupling. The tissue transglutaminase (tTG) antigen was immobilized on PAMAM to form nanoprobe for sensing specific anti-tissue transglutaminase (anti-tTG) antibodies (immunoglobin A isotype) in human serum. The electrochemical changes after specific binding of antibody with antigen was measured cyclic voltammetry (CV) and differential pulse voltammetry (DPV). The modifications in sensor surface were characterized using FE-SEM. The sensor is highly specific to anti-tissue transglutaminase antibodies and showed negligible response to non-specific serum proteins. The sensitivity of the sensor was 1297.14 μA/cm 2 /pg with DPV and lower limit of detection of anti-tissue transglutaminase antibody was found 0.1fg per 6 μl. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is a gluten-dependent autoimmune disorder affecting a significant percentage of the general population, with increasing incidence particularly for children. Reliable analytical methods suitable for the serological diagnosis of the disorder are urgently required for performing both the early diagnosis and the follow-up of a patient adhering to a gluten-free diet. Herein we report on the preparation and application of a novel electrochemical immunosensor based on the use of ensembles of gold nanoelectrodes (NEEs) for the detection of anti-tissue transglutaminase (anti-tTG), which is considered one reliable serological marker for CD. To this end, we take advantage of the composite nature of the nanostructured surface of membrane-templated NEEs by functionalizing the polycarbonate surface of the track-etched membrane with tissue transglutaminase. Incubation of the functionalized NEE in anti-tTG samples results in the capture of the anti-tTG antibody. Confirmation of the recognition event is achieved by incubating the NEE with a secondary antibody labelled with horseradish peroxidase (HRP): in the presence of H2O2 as substrate and hydroquinone as redox mediator, an electrocatalytic current is indeed generated whose increment is proportional to the amount of anti-tTG captured from the sample. The optimized sensor allows a detection limit of 1.8 ng mL−1, with satisfactory selectivity and reproducibility. Analysis of serum samples from 28 individuals, some healthy and some affected by CD, furnished analytical results comparable with those achieved by classical fluoroenzyme immunoassay (FEIA). We note that the NEE-based immunosensor developed here detects the IgG isotype of anti-tTG, while FEIA detects the IgA isotype, which is not a suitable diagnostic marker for IgA-deficient patients.

Background and Aim Celiac disease is a multi-systemic disease, which can affect any organ system including liver. However, the prevalence of celiac disease and the sensitivity and specificity of anti-tissue transglutaminase (anti-tTG) in diagnosing celiac disease in patients with cirrhosis of liver is not well established. Methods We screened a cohort of patients with chronic liver disease for an associated diagnosis of celiac disease. Anti-tTG was carried out in all patients, and those with a high value were subjected to duodenal biopsy for histological confirmation. In patients where biopsy was contraindicated or refused, anti-endomysial antibody (anti-EMA) was tested. Results Of a total of 595 patients with chronic liver disease, high levels of anti-tTG were noted in 150 (25.2%) patients, and celiac disease was diagnosed in 14 patients (2.4%). Celiac autoimmunity (high levels of both anti-tTG and anti-EMA) was noted in seven patients (1.2%). Conclusions Although a large number of cirrhotic patients have high levels of anti-tTG, duodenal histology and/or anti-EMA is normal in majority of these patients. This suggests high false positivity of anti-tTG in patients with cirrhosis and highlights the need of duodenal biopsy for histological confirmation of the diagnosis of celiac disease. [ABSTRACT FROM AUTHOR]

Objective: Published studies on the prevalence of celiac disease in type 1 diabetes mellitus from the Arab World are scant. We aim to report the prevalence of celiac disease in Omani children with type 1 diabetes mellitus.Methods: Children with type 1 diabetes mellitus were prospectively screened for celiac disease, at Sultan Qaboos University Hospital, Muscat, Oman over a period of one year (June 2011 - May 2012). Serum anti tissue transglutaminase IgA, endomysial IgA antibodies and total IgA were measured for screening of celiac disease. Children with positive anti-tissue transglutaminase and/or endomysial IgA antibodies underwent endoscopy.Results: A total of 103 children with type 1 diabetes mellitus were initially included. Ten patients were lost to follow up. Ninety-three patients aged 2-17 years underwent screening for celiac disease. Sixteen patients had positive anti-tissue transglutaminase (17%). Fourteen patients underwent endoscopy with duodenal biopsies, while two were lost to follow-up. Five patients with positive anti-tissue transglutaminase had intestinal biopsy proven celiac disease. The prevalence of celiac disease is 5.5% in our cohort of children and adolescents with type 1 diabetes mellitus.Conclusions: The prevalence of celiac disease in Omani children and adolescents with type 1 diabetes mellitus is similar to the World’s reported prevalence, but is less than that reported for Middle Eastern Arab children. To our knowledge, this is the first reported study on the prevalence of celiac disease in Omani children with type 1 diabetes mellitus.

Objective: a strong association has been observed between celiac disease, generally its silent clinical form, and autoimmune disorders. A potential correlation with inflammatory bowel disease has also been suggested. Anti-tissue transglutaminase antibodies have been detected in Crohn's disease. We investigated the prevalence of celiac disease in patients with autoimmune diabetes and in Crohn's disease patients and also evaluated the correlation between anti-transglutaminase antibody positivity and the clinical status of these diseases. Methods: anti-tissue transglutaminase and anti-endomysium antibodies were assessed by enzyme-linked immunosorbent assay and indirect immunofluorescence, respectively. Upper digestive endoscopy and duodenal biopsy were indicated for cases with positive serology. Results: anti-transglutaminase antibodies were detected in five diabetic patients (prevalence of 11.1%), only one serum sample was positive for IgG isotypes. Nine of thirty-three patients with Crohn's disease had low positive levels for IgA anti-transglutaminase. Anti-endomysium antibodies were detected only in celiac patients. Celiac disease was confirmed in all diabetic patients submitted to duodenal biopsies who presented both anti-transglutaminase and anti-endomisyum antibodies positivity. In Crohn's disease, its clinical status and the diagnosis of celiac disease were not associated with positive anti-transglutaminase result. Conclusions: the prevalence of celiac disease was high in diabetic patients. Anti-tissue transglutaminase antibodies were sensitive and specific markers of celiac disease in this diabetic group, while these antibodies were of limited value for celiac disease screening in patients with Crohn's disease.

Objectives: The aim behind this study was to determine the frequency of Celiac disease in patients presenting with Iron deficiency anemia at tertiary care hospital. Study Design: Descriptive cross sectional hospital based study. Setting: Non-probability consecutive sampling technique in a department of medicine at Medical Unit II, People's Medical University, Shaheed Benazeerabad. Period: Six months from 26th October 2014 to 25th April 2015. Patients and Methods: A standard sample bottle was used to collect the blood sample from the peripheral vein followed by testing for Anti-tissue transglutaminase antibodies (tTG) and anti-endomysial antibodies (EMA). On these patients upper GI endoscopy for jejunal biopsy was done by an expert having an experience of >5 years in relevant field. Data regarding Hemoglobin, anti tTG antibodies, anti Endomysial antibodies and diagnosis of celiac disease (outcome variable) were collected. Data were entered and analyzed by using Statistical Package for the Social Sciences version 20.0. Results: Out of total 77 patients, the mean age and SD of age and hemoglobin levels were 37.65±11.26 years and 8.81±1.23 g/dl, respectively. Celiac disease (CD) Positive finding was observed in 27.27% cases by anti-tTG antibodies and in 16.88% cases by anti-endomysial antibodies. Prevalenc Frequency of celiac disease in patients presenting with iron deficiency anemia was observed in Around 12.99% (10/77) of the cases who had underlying iron deficiency anemia were observed to have concomitant. Conclusion: There is a high prevalence of Celiac disease in patients presenting with Iron deficiency anemia. Early deduction and prompt treatment should be necessary for this disease. Screening of celiac disease by anti-tissue transglutaminase antibody should be done as a routine investigation in patient with iron-deficiency anemia. [ABSTRACT FROM AUTHOR]

Background: The European Society for Pediatric Gastroenterology and Nutrition states that if IgA anti-tissue transglutaminase (tTG) exceeds 10 times the upper limit of normal (ULN), there is the possibility to diagnose celiac disease (CD) without duodenal biopsy, if supported by anti-endomysium testing and human leukocyte antigen (HLA) typing. We aimed to evaluate whether combining IgA tTG and IgG anti-deamidated gliadin peptide (DGP) antibody testing and taking into account the antibody levels improves clinical interpretation. Methods: We calculated likelihood ratios for various test result combinations using data obtained from newly diagnosed CD patients (n = 156) [13 children < 2 years, 45 children between 2 and 16 years, and 98 adults (> 16 years)] and 974 disease controls. All patients and controls underwent duodenal biopsy. IgA anti-tTG and IgG anti-DGP assays were from Thermo Fisher and Inova. Results: Likelihood ratios for CD markedly increased with double positivity and increasing antibody levels of IgA anti-tTG and IgG anti-DGP. Patients with double positivity and high antibody levels (> 3 times, > 10 times ULN) had a high probability for having CD (likelihood ratio e 649 for > 3 times ULN and ∞ for > 10 times ULN). The fraction of CD patients with double positivity and high antibody levels was 59%-67% (depending on the assay) for > 3 ULN and 33%-36% (depending on the assay) for > 10 ULN, respectively. This fraction was significantly higher in children with CD than in adults. Conclusions: Combining IgG anti-DGP with IgA anti-tTG and defining thresholds for antibody levels improves the serologic diagnosis of CD. [ABSTRACT FROM AUTHOR]

Copyright of Al-Qadisiah Medical Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study is to assess the prevalence of isolated short stature as a clinical presentation of celiac disease in Saudi Arab children and whether some of the routine labora-tory tests performed to determine the cause of short stature could suggest the diagnosis of celiac disease. A total of 91 children with short stature were included in the study. Extensive endocrine and biochemical assessments, including total protein, serum albumin, calcium phosphate and alkaline phosphatase assays; renal function tests; coagulation profile; anti-endomysial antibodies and anti-tissue transglutaminase antibody, growth hormone, thyroid stimulating hormone, free-thyroxin (FT4) assays; stool tests for giardiasis; bone age; and endoscopic intestinal biopsies, were done for all children. Ten of the 91 children had positive intestinal biopsies in the form of total villous atrophy, an increase in crypt height, and an increase in intra-epithelial lymphocyte (IEL) numbers up to >40 IEL/100 EC (Type 3C) according to the Oberhuber classification, confirming the diagnosis of celiac disease. Five children had mild villous atrophy according to this classification (Type 3A), and they were considered to have potential celiac disease. Seventy-six children had normal intestinal biopsies. Therefore, the prevalence of celiac disease among Saudi children with short stature was 10.9%, and 4.3% of the children were diagnosed as having potential celiac disease. After confirming the diagnosis of celiac disease, all children were kept on a gluten-free diet and all of them showed improvement in their growth rate. We concluded that celiac disease is a very important cause of short stature in children without gastrointestinal complaints in Saudi Arabia. We highly recommend anti-tissue transglutaminase and anti-endomysial antibody screening tests, and a small bowel biopsy to confirm the diagnosis of celiac disease irrespective of the results of the antibody assays, in children with short stature in Saudi Arabia. Once the diagnosis is confirmed, children should be kept on a gluten-free diet so they can catch up their growth early before they develop permanent short stature.

Abstract: Objective: To identify the prevalence of celiac disease (CD) among children with short stature. Celiac disease (CD) is genetically determined gluten-sensitive enteropathy resulting in nutrient malabsorption, with an increasing incidence world-wide. A retrospective, hospital based study is conducted at a pediatric endocrine clinic, King Khalid University Hospital, Riyadh. Methods: During the period between January 1990 and December 2009, the medical records of patients evaluated for short stature were reviewed. After a proper detailed history and physical examination, growth analysis, followed by radiological (bone age), and laboratory screening (CBC, and thyroid function) were performed. Celiac serological screening and chromosomal analysis were performed when appropriate, followed by small intestinal biopsy if indicated. Growth hormone stimulation test was performed in suspected patients, followed by magnetic resonance imaging (MRI) in positive cases. Results: Hundred and ten patients were evaluated for short stature over the period under review. Their age ranged from 2.6 to 14years. The male to female ratio was 1.3:1. The commonest cause was genetic and found in approximately 51.8%, while in the other 48.2%, variable endocrine and non-endocrine causes were noted. Of the non-genetic short stature, 5 (10%) patients were found to have celiac disease, i.e. 4.5% of short children. Conclusion: The prevalence of celiac disease is not rare in this study, therefore, celiac disease must be considered as an important cause of short stature. As, it could be a silent disease, it is recommended that a serological screening be done first to all patients before performing dynamic growth hormone testing in the evaluation of short stature. [Copyright &y& Elsevier]

Objective: Published studies on the prevalence of celiac disease in type 1 diabetes mellitus from the Arab World are scant. We aim to report the prevalence of celiac disease in Omani children with type 1 diabetes mellitus. Methods: Children with type 1 diabetes mellitus were prospectively screened for celiac disease, at Sultan Qaboos University Hospital, Muscat, Oman over a period of one year ( June 2011 - May 2012). Serum anti tissue transglutaminase IgA, endomysial IgA antibodies and total IgA were measured for screening of celiac disease. Children with positive anti-tissue transglutaminase and/or endomysial IgA antibodies underwent endoscopy. Results: A total of 103 children with type 1 diabetes mellitus were initially included. Ten patients were lost to follow up. Ninety-three patients aged 2-17 years underwent screening for celiac disease. Sixteen patients had positive anti-tissue transglutaminase (17%). Fourteen patients underwent endoscopy with duodenal biopsies, while two were lost to follow-up. Five patients with positive anti-tissue transglutaminase had intestinal biopsy proven celiac disease. The prevalence of celiac disease is 5.5% in our cohort of children and adolescents with type 1 diabetes mellitus. Conclusions: The prevalence of celiac disease in Omani children and adolescents with type 1 diabetes mellitus is similar to the World's reported prevalence, but is less than that reported for Middle Eastern Arab children. To our knowledge, this is the first reported study on the prevalence of celiac disease in Omani children with type 1 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objectives To study the prevalence of antibodies of IgA class against tissue transglutaminase ( tTG), endomysium (EMA) and gliadin (AGA) in patients with chronic idiopathic axonal polyneuropathy (CIAP) and to characterize the patients clinically and neurophysiologically. Methods Of 182 patients, 126 patients agreed to blood sampling. Sera were analysed by ELISAs detecting anti- tTG and AGA, whereas EMA was analysed by indirect immunofluorescence (IF) microscopy. Gastrointestinal symptoms were assessed by data from medical records and patient interviews. Results Nine of 126 patients (7%) were seropositive in at least one test (five with positive anti- tTG and/or EMA and four with positive AGA only). One patient with elevated levels of all specificities had laboratory signs of malabsorption and gastrointestinal complaints with abdominal pain and diarrhoea. Conclusions Elevated levels of IgA-AGA were slightly more frequent in patients with CIAP (4%) compared to 2.5% in 1866 healthy blood donors. Highly specific serological markers indicative of coeliac disease (CD) (anti- tTG and EMA) were somewhat more common in our patients with CIAP (4%) than expected from normal reference values and from studies of the prevalence of CD in the general population. Even though these findings may indicate a relationship, the aetiological importance is unclear. [ABSTRACT FROM AUTHOR]

Abstract: Background and study aims: Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder and coeliac disease (CD) is an auto-immune enteropathy that can mimic almost any functional GI disorder. Both IBS and coeliac disease share common symptoms. The aim of the present study was to estimate the prevalence of CD in patients with IBS and its sub-types. Patients and methods: In this cross-sectional study (2008–2010), all consecutive patients with IBS who fulfilled the Rome III criteria attending the GI units in Zahedan (Southeast Iran) were included. Patients based on the sub-type of IBS were classified as diarrhoea-predominant irritable bowel syndrome (D-IBS), constipation-predominant irritable bowel syndrome (C-IBS) and alternating symptoms (mixed type). Immunoglobulin A (IgA) tissue transglutaminase (anti-tTG) was used to screen patients for CD. In the case of positive serologic test, duodenal biopsies were taken to confirm the diagnosis. Results: A total of 364 (221 females and 143 males) patients with IBS were included. The mean±standard deviation (SD) age of patients was 37.4±12.4years. Twenty (5.5%) patients were found to have positive IgA anti-tTG. Main symptoms of patients were diarrhoea (11/20), bloating (10/20) and abdominal distension (6/20). Thirteen (10.5%) patients were found to have positive IgA anti-tTG among the D-IBS, two (1.6%) in the C-IBS and five (4.2%) in M-IBS groups. Conclusion: The prevalence of CD in IBS is high. IBS subjects whose main complaint is diarrhoea, bloating or even abdominal distension should be evaluated for CD. [Copyright &y& Elsevier]

Background: There is lack of data on prevalence of celiac disease (CD) in children with type 1 diabetes (T1D) in Arabs in the Middle East. The present investigation aims to study the prevalence rate and clinical characteristics of CD among Saudi children with T1D using a combination of the most sensitive and specific screening serologic tests (anti- tissue transglutaminase antibodies IgA [anti-TTG] and ednomyseal antibodies [EMA]) and to determine the lower cut-off value of anti- anti-TTG level that best predicts CD in children with T1D. Methods: Children with T1D following in diabetic clinic have been prospectively screened for presence of CD, over a two-year period (2008-2010), by doing anti-TTG, EMA, and total IgA. Children with positive anti-TTG titres (>50 U/ml) and/or EMA and children with persistently low positive anti-TTG titres (two readings 20-50 U/ml; within 6 months intervals) had upper endoscopy and 6 duodenal biopsies. Results: One hundred and six children with T1D have been screened for CD: age ranged between 8 months to 15.5 years (62 females). Nineteen children had positive anti-TTG and/or EMA, however only 12 children had biopsy proven CD (11.3%). Five of 12 had gastrointestinal symptoms (42%). Children with T1D and CD had significantly lower serum iron than children with T1D alone (8.5 µgm/L Vs 12.5 µgm/L; P = 0.014). The sensitivity and specificity of anti-TTG were 91.6% and 93.6%, with a positive and negative predictive value of 64.7% and 98.8%, respectively. Receiver operated characteristics analysis for the best cut-off value of anti-TTG level for diagnosis of CD was 63 units (sensitivity 100% and specificity 98.8%). Conclusion: CD is highly prevalent among Saudi children with T1D. Anti-TTG titres more than 3 times the upper limit of normal has very high sensitivity and specificity for diagnosis of CD in T1D children. [ABSTRACT FROM AUTHOR]

Abstract: Celiac disease is an autoimmune disorder that affects the gastrointestinal tract upon ingestion of gluten, which triggers the production of antibodies against gliadin and tissue transglutaminase, activating an inflammatory response and inducing tissue damage in the small intestine resulting in malabsorption. The measurement of these antibodies in an individual''s blood can be used to screen for celiac disease and the criteria for definitive diagnosis is currently being revised to be based on serological analysis rather than biopsy. In the work reported here, an electrochemical immunosensor for the detection of human anti-tissue transglutaminase antibodies was developed, consisting of gold-based self-assembled monolayers of a carboxylic group terminated bipodal alkanethiol that is covalently linked to tissue transglutaminase, the antigen for the immunorecognition of circulating autoantibodies. The presence of the autoantibodies was recorded using horseradish peroxidase labeled anti-human antibodies, which provided an enzyme based electrochemical signal. Optimization and characterization of the surface of the sensor was carried out by electrochemical impedance spectroscopy and surface plasmon resonance. The immunosensor gave a stable quantitative response to different antibody concentrations after 30min with a limit of detection of 390ng/mL and an RSD of 9%, n =3. The developed immunosensor was tested with calibrator solutions as well as with real patients’ samples, and the results compared to those obtained from Eurospital''s Eu-tTG IgA and IgG ELISA kits, showing an excellent degree of correlation. [Copyright &y& Elsevier]

To investigate, in patients with suspected celiac disease (CD) younger than 2 years, the clinical value of anti-tissue transglutaminase (tTG) in diagnostic work-up of CD. Between June 2005 and June 2009, 169 patients aged <2 years, with symptoms suggestive of CD, were submitted to biopsy. CD diagnosis was based on the revised criteria of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Of the 169 patients enrolled, 155 were included: 108 of them showed mucosal atrophy and 47 negative histology. Sensitivity and specificity of tTG, at the cut-off of 8 AU/mL, were 0.96 (CI 0.91-0.99) and 0.91 (CI 0.80-0.98), respectively, with likelihood ratio (LR) of 11.31; at the cut-off of 16 AU/mL, they were 0.79 (CI 0.70-0.86) and 1.00, respectively (CI 0.92-1.00), with LR 4.50. In patients younger than 2 years, suspected for CD, tTG is very valuable in selecting for small intestinal biopsy. [ABSTRACT FROM AUTHOR]

This prospective study was planned with the aim to determine the prevalence of anti-tissue transglutaminase in children and adolescents with severe short stature (<-3 SD) attending the Pediatric outpatient, inpatient and/or the Pediatric Gastroenterology clinic. All children in age group of 1–18 years having height less than -3 SD for their age and sex, were included. For each child age and sex matched healthy control (height more than -2 SD) was taken. The included subjects (study & control group) were subjected to anti tissue transglutaminase (tTG) (IgA) antibody assay estimation. Of the 112 cases, 23 were tTG positive, giving a prevalence of 20.5% for seropositivity among cases of short stature while all the controls were seronegative for tTG. All the 23 had tTG values above 40 U/ml and 11 had values above 100 U/ml. On univariate analysis we found that the presence of chronic diarrhea (OR = 2.55, 95%CI − 1.08–5.98), bulky stools (OR = 3.03, 95%CI − 1.52–6.05), hemoglobin < 7 gm/dl (OR = 3.12, 95%CI − 1.55–6.29) and more severe short stature (<-4 SD) (OR = 0.41, 95%CI − 0.17–0.95) had significant association with the tTG positivity. On logistic regression analysis in all cases, hemoglobin < 7gm/dl (OR = 0.090, 95%CI = 0.024–0.342) and bulky stools (OR=0.212, 95%CI = 0.069–0.649) were significantly associated with tTG positivity. More than one fifth of all severe short stature are seropositive for tTG and the chances of seropositivity increases if severe anemia and bulky stool are also associated. [ABSTRACT FROM AUTHOR]

Objectives: Atypical presentation is the most prevalent form of coeliac disease (CD) and mostly clinically indistinguishable from other gastrointestinal (GI) disorders. The first objective of this study was to determine the prevalence of CD in patients with GI symptoms and the second objective was to characterize the typical manifestations of the atypical forms of CD. Methods: This was a cross sectional study comprising 5,176 individuals by. random sampling of self-referred people from the Tehran province, during the years 2006-2007 in a primary care setting. From 5,176 individuals, 670 with GI symptoms were selected for coeliac serology including total immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG) antibodies. Those with IgA deficiency were tested with IgG tTG. Results: This study shows that 13% (670/5176) of self-referred patients to a general practice suffer from GI symptoms. Dyspepsia was the most common symptom in 25 seropositive cases similar to the rest of the study group. A positive anti-tTG test was found in 22 from 670 investigated subjects (17 women, 5 men) (95% CI: 1.70-4.30) and 8/670 were IgA deficient. A positive IgG tTG was detected in 3/8 IgA deficient individuals. The prevalence of CD antibodies in serologically screened samples excluding IgA-deficient was 3.3% and 3.7% when including those IgA-deficient with positive tTG-IgG. Conclusions: Non-specific GI symptoms seem to be the typical presentation of atypical CD. This study indicated that there is a high prevalence of CD antibodies among patients with GI symptoms (3.7%). More awareness regarding the atypical presentation of CD could be the key step in identifying asymptomatic patients. [ABSTRACT FROM AUTHOR]

Presents an index related to pharmacology published in the June 15, 2003 issue of the journal 'Alimentary Pharmacology & Therapeutics.'

Introduction & Aim: Anti-tissue transglutaminase antibody (tTGA) titer is used during the follow-up of celiac patients to evaluate gluten-free diet (GFD) responsiveness. However, no clear data are available on this issue. The aim of this study was to evaluate tTGA significance during celiac disease (CD) monitoring. Methods: From January 2017 to January 2020, consecutive CD patients on a GFD with persistent positive tTGA were enrolled. Antibody titres were evaluated on a yearly basis from CD diagnosis to the last follow-up. Urinary gluten detection tests, duodenal histology and capsule enteroscopy (CE) were performed. A tTGA-positive cohort was compared with a control group composed of 212 treated CD patients with negative tTGA. Results: 65 patients (12% males, median age at enrollment and CD diagnosis, 37 (14–86) and 31 (1–76), respectively, median follow up 4 (1–26) years) presented with positive tTGA during follow-up. Overall, the tTGA titres were 3 (1–79) fold increased (ULN). Three different tTGA trends were recognized: (I) 36 (55%) patients with a progressive titres decrease; (II) 16 (25%) patients with a fluctuating behavior; (III) 13 (20%) patients with a steady state or increased titres. tTGA+ patients did not present with different clinical and demographic parameters. Duodenal atrophy was present in 10% vs. 36% of the tTGA positive vs. negative group (p < 0.005), respectively. Gluten detection results were positive in 3 (8%) cases, all in the III group. In tTGA+ patients, CE did not identify any CD-related complications. Conclusions: tTGA positivity during CD follow up did not present a relevant clinical significance without association with autoimmune comorbidities and mucosal damage. [ABSTRACT FROM AUTHOR]

Abstract: Background and study aims: Coeliac disease (CD) may be associated with several liver disorders including primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis. Furthermore preliminary data suggest a causative role of CD in steatosis and steatohepatitis. The aim of present study was to determine the prevalence of CD in a series of patients with non-alcoholic fatty liver disease (NAFLD). Patients and methods: In a cross sectional study (2008–2010), 403 consecutive NAFLD patients (127 female and 276 male) referred to GI clinics of the Zahedan University of Medical Sciences were included. IgA anti-tissue transglutaminase (Anti-tTG) was used for screening of coeliac disease. In the patients with a positive serologic test, duodenal biopsies were taken to confirm the diagnosis. Results: The mean±SD of the age and BMI of patients were 37.4±12.4years and 28.3±4.15kg/m2 respectively. BMIs lower than 25kg/m2 were found in 58 subjects (14.5%). Furthermore diabetes mellitus and hyperlipidaemia were diagnosed in 48 (11.9%) and 84 (20.8%) individuals respectively. Positive Anti-tTGs were found in 14/403 (3.4%) and 13/403 (3.2%, 95% CI 1.5–4.9) had coeliac disease according to the modified Marsh classification; 8 had type I, 3 type II, 1 type IIIA and 1 type IIIB lesions. Conclusion: According to our data, prevalence of CD in the subjects with NAFLD is higher than the rates reported in the general population. Therefore screening for CD in selected cases of NAFLD may be appropriate. [Copyright &y& Elsevier]

Celiac disease (CD) is an enteric disease caused by dietary gluten in individuals with genetic predisposition. One of the clinical manifestations of CD is the peripheral arthritis that may simulate RA. Objective: To determine the frequency of anti-gliadin (aGL), anti-tissue transglutaminase (aTGT) and ultra purified anti-gliadin (AGLU) antibodies in patients with RA. Methods: Cross-sectional study. We included consecutive patients diagnosed as RA (ACR). Demographic and clinical data was registered by direct interview and serum levels of aGL, aTGT y aGLU were determined using ELISA. Results: Eighty-five RA patients were included; 87% were women. Mean age was 44±12 years, mean disease duration 12 ±9 years. aGL IgG antibodies were positive in 16 patients, IgA aGL antibodies in 29 patients, aGLU in 14 patients and only one patient had aTGT. Conclusions: It is possible that CD may be the correct diagnosis in a patient with polyarthritis, even if the patient meets the ACR criteria for RA. In other words, CD should be considered among the differential diagnoses in a patient with poly-arthritis. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the prevalence of isolated short stature as a clinical presentation of celiac disease in Saudi Arab children and whether some of the routine laboratory tests performed to determine the cause of short stature could suggest the diagnosis of celiac disease. A total of 91 children with short stature were included in the study. Extensive endocrine and biochemical assessments, including total protein, serum albumin, calcium phosphate and alkaline phosphatase assays; renal function tests; coagulation profile; anti-endomysial antibodies and anti-tissue transglutaminase antibody, growth hormone, thyroid stimulating hormone, free-thyroxin (FT4) assays; stool tests for giardiasis; bone age; and endoscopic intestinal biopsies, were done for all children. Ten of the 91 children had positive intestinal biopsies in the form of total villous atrophy, an increase in crypt height, and an increase in intra-epithelial lymphocyte (IEL) numbers up to >40 IEL/100 EC (Type 3C) according to the Oberhuber classification, confirming the diagnosis of celiac disease. Five children had mild villous atrophy according to this classification (Type 3A), and they were considered to have potential celiac disease. Seventy-six children had normal intestinal biopsies. Therefore, the prevalence of celiac disease among Saudi children with short stature was 10.9%, and 4.3% of the children were diagnosed as having potential celiac disease. After confirming the diagnosis of celiac disease, all children were kept on a gluten-free diet and all of them showed improvement in their growth rate. We concluded that celiac disease is a very important cause of short stature in children without gastrointestinal complaints in Saudi Arabia. We highly recommend anti-tissue transglutaminase and anti-endomysial antibody screening tests, and a small bowel biopsy to confirm the diagnosis of celiac disease irrespective of the results of the antibody assays, in children with short stature in Saudi Arabia. Once the diagnosis is confirmed, children should be kept on a gluten-free diet so they can catch up their growth early before they develop permanent short stature. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes is an autoimmune disorder with a high risk of celiac disease (CD)., Aim: This study aimed to determine the celiac autoantibody status and the clinical characteristics among children with type 1 diabetes and autoantibody positivity for CD compared to those without serological evidence of CD., Materials and Methods: In this cross-sectional study, 240 children with type 1 diabetes underwent serological screening CD. Blood glucose, glycated hemoglobin (HbA1c), hemoglobin, calcium, phosphorous, Vitamin D, alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were evaluated. The participants were screened for human anti-endomysial antibody and human anti-tissue transglutaminase antibody., Results: Of the 240 children with type 1 diabetes, 66 children were antibody positive for either anti-endomysial or anti-tissue transglutaminase or both autoantibodies for CD. There were 36 (54.5%) female and 30 (45.5%) male children with the mean age of 15.5±2.1 years. The mean duration of diabetes was 6.8±3.8 years. Only 35 (14.6%) children were found to have serological evidence of CD., Conclusion: CD is associated with type 1 diabetes. Serological screening for CD autoantibody should be performed routinely in children with type 1 diabetes. There is discrepancy in screening CD with antibodies, so a prospective follow-up of this cohort is needed for endoscopic evaluation and histopathological examination of intestinal biopsy to confirm CD in this population., Relevance for Patients: Anti-endomysial and anti-tissue transglutaminase autoantibodies should be included for screening CD among children with type 1 diabetes. Patients should undergo an endoscopy to confirm a diagnosis of CD., (Copyright © 2020, Whioce Publishing Pte. Ltd.)

Celiac disease (CD) is a gluten-dependent autoimmune disorder affecting a significant percentage of the general population, with increasing incidence particularly for children. Reliable analytical methods suitable for the serological diagnosis of the disorder are urgently required for performing both the early diagnosis and the follow-up of a patient adhering to a gluten-free diet. Herein we report on the preparation and application of a novel electrochemical immunosensor based on the use of ensembles of gold nanoelectrodes (NEEs) for the detection of anti-tissue transglutaminase (anti-tTG), which is considered one reliable serological marker for CD. To this end, we take advantage of the composite nature of the nanostructured surface of membrane-templated NEEs by functionalizing the polycarbonate surface of the track-etched membrane with tissue transglutaminase. Incubation of the functionalized NEE in anti-tTG samples results in the capture of the anti-tTG antibody. Confirmation of the recognition event is achieved by incubating the NEE with a secondary antibody labelled with horseradish peroxidase (HRP): in the presence of H2O2 as substrate and hydroquinone as redox mediator, an electrocatalytic current is indeed generated whose increment is proportional to the amount of anti-tTG captured from the sample. The optimized sensor allows a detection limit of 1.8 ng mL−1, with satisfactory selectivity and reproducibility. Analysis of serum samples from 28 individuals, some healthy and some affected by CD, furnished analytical results comparable with those achieved by classical fluoroenzyme immunoassay (FEIA). We note that the NEE-based immunosensor developed here detects the IgG isotype of anti-tTG, while FEIA detects the IgA isotype, which is not a suitable diagnostic marker for IgA-deficient patients. [ABSTRACT FROM AUTHOR]

According to the 2012 ESPGHAN criteria for diagnosis of celiac disease (CD), duodenal biopsy (DB) can be avoided in children with a clear malabsorption syndrome, anti-tissue transglutaminase IgA (tTG2) ≥ 10x the cut-off, anti-endomysium IgA (EMA) and HLA DQ2/DQ8 genes. The aim of this study is to report our experience and evaluate the accuracy of the actual guidelines., Patients and Methods: This is a retrospective study conducted on all patients diagnosed CD from 2012 to 2018 in our Center. For all patients enrolled were analyzed: data of family history, symptoms, serology, genetics, Marsh grade and follow-up., Results: A total of 481 children [mean age 6,4 yrs; F:M= 1.8:1] were included in the study. The mean age of patients who were not subject to DB was lower (4.51 yrs) comparing with patients that received DB (6.48 yrs). Out of the 256 patients with anti-tTG2 ≥ 10 fold, 121 underwent DB because of mild symptoms (84/121) or no symptoms (37/121). In all cases Marsh type 3 was found and HLA haplotypes was compatible with CD diagnosis., Conclusions: Our study confirms that the serology has a primary importance to diagnose CD, regardless of the symptoms. These data suggest that biopsy and HLA haplotypes search, in presence of anti-tTG2 IgA ≥ 10x the cut-off, are wasteful and unhelpful for the patients.