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1.
World J Gastroenterol ; 27(20): 2603-2614, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34092978

RESUMO

BACKGROUND: Long-term outcomes and monitoring patterns in real-world practice are largely unknown among patients with celiac disease. AIM: To understand patterns of follow-up and management of patients with celiac disease, and to characterize symptoms and villous atrophy after diagnosis. METHODS: A retrospective chart review study was performed using medical chart data of patients diagnosed with celiac disease. Three gastroenterology referral centers, with substantial expertise in celiac disease, participated in the United Kingdom, United States, and Norway. Demographic and clinical data were collected from medical charts. Descriptive analyses were conducted on patients with biopsy-confirmed celiac disease, diagnosed between 2008 and 2012, with at least one follow-up visit before December 31, 2017. Patient demographic and clinical characteristics, biopsy/serology tests and results, symptoms, and comorbidities were captured at diagnosis and for each clinic visit occurring within the study period (i.e., before the study end date of December 31, 2017). RESULTS: A total of 300 patients were included in this study [72% female; mean age at diagnosis: 38.9 years, standard deviation (SD) 17.2]. Patients were followed-up for a mean of 29.9 mo (SD 22.1) and there were, on average, three follow-up visits per patient during the study period. Over two-thirds (68.4%) of patients were recorded as having ongoing gastrointestinal symptoms and 11.0% had ongoing symptoms and enteropathy during follow-up. Approximately 80% of patients were referred to a dietician at least once during the follow-up period. Half (50.0%) of the patients underwent at least one follow-up duodenal biopsy and 36.6% had continued villous atrophy. Patterns of monitoring varied between sites. Biopsies were conducted more frequently in Norway and patients in the United States had a longer follow-up duration. CONCLUSION: This real-world study demonstrates variable follow-up of patients with celiac disease despite most patients continuing to have abnormal histology and symptoms after diagnosis.


Assuntos
Doença Celíaca , Biópsia , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Feminino , Humanos , Masculino , Noruega , Estudos Retrospectivos , Reino Unido , Estados Unidos
2.
Medicina (Kaunas) ; 57(6)2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34073654

RESUMO

Non-celiac gluten sensitivity (NCGS) is a clinical entity characterized by the absence of celiac disease and wheat allergy in patients that trigger reproducible symptomatic responses to gluten-containing foods consumption. Due to the lack of sensitive and reproducible biomarkers for NCGS diagnosis, placebo-controlled gluten challenges must be carried out for its diagnosis. The gluten challenges can be either double- or single-blind, for research or clinical practice purposes, respectively. For improving our understanding about the magnitude and relevance of NCGS in different populations, epidemiological studies based on self-report have been carried out. However, the gluten challenge-based prevalence of NCGS remains to be estimated. Since NCGS was recently recognized as a clinical entity, more studies are needed to delve into NCGS pathogenesis, for instance, the molecular interactions between the suspected cereal grain components that trigger NCGS, such as fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) and amylase and trypsin inhibitors, and the immune system remains to be elucidated. Although still under debate, NCGS patients can be susceptible to only one or more than one of the NCGS triggers. The treatment of NCGS involves the dietary restriction of the suspected triggers of the disease, but there is controversial data about the effectiveness of different dietary interventions such as the gluten-free diet and low-FODMAP diet. Certainly, our understanding of NCGS is improving quickly due to the constant availability of new scientific information on this topic. Thus, the aim of the present narrative review is to present an up-to-date overview on NCGS from epidemiology to current therapy.


Assuntos
Doença Celíaca , Hipersensibilidade Alimentar , Hipersensibilidade a Trigo , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Dieta Livre de Glúten , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/epidemiologia , Glutens/efeitos adversos , Humanos , Método Simples-Cego
3.
Zhonghua Nei Ke Za Zhi ; 60(6): 539-543, 2021 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-34058810

RESUMO

Objective: To determine the seroprevalence of celiac disease in susceptible population, and to analyze the relationship between demographic characteristics, dietary habits, lifestyle and serological positivity so as to provide guidance for the prevention and treatment of celiac disease in Southern China. Methods: A total of 1 273 individuals who participated in Guangdong Province Health Screening Program in 2015, were selected as serologically positive subjects of celiac disease, including people with irritable bowel syndrome, colitis, diarrhea, anemia, low BMI, short stature, type 1 diabetes mellitus (T1DM), rheumatoid arthritis (RA), ankylosing spondylitis, psoriasis and bristol grade=6 or 7. All subjects were tested for serum IgA anti-tissue transglutaminase antibodies (TTGA), IgA antibodies against deamidated gliadin peptides(DGPA) and IgG against deamidated gliadin peptides (DGPG). Dietary habits, lifestyle and demographic characteristics were compared in subgroups. Results: The seroprevalence of celiac disease in susceptible population was 0.94% (95%CI 0.54%-1.64%) including 0.08% (1/1 273) for TTGA, 0.47% (6/1 273) for DGPA, and 0.39% (5/1 273) for DGPG. The seropositive rate was 3.6% (1/28) in patients with psoriasis, 2.1% (2/95) in the low BMI group, 1.9% (1/53) in T1DM group, 1.8% (3/169) in diarrhea group and 1.1% (5/463) in RA group. No significant difference was found in age, gender, high carbohydrate diet or lifestyle between the negative and the positive subjects. Conclusions: In Southern China, the seropositive rate of celiac disease is 0.94% in susceptible population, which prompts an urgent need of serological screening for early diagnosis.


Assuntos
Doença Celíaca , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , China/epidemiologia , Ensaio de Imunoadsorção Enzimática , Gliadina , Humanos , Imunoglobulina G , Estudos Soroepidemiológicos
4.
J Int Med Res ; 49(5): 3000605211012258, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33983054

RESUMO

Celiac disease (CD) is a chronic immune-mediated intestinal disease that is characterized by production of autoantibodies directed against the small intestine. The main clinical manifestations of CD are typically defined as those related to indigestion and malabsorption. These manifestations include unexplained diarrhea or constipation, abdominal pain, bloating, weight loss, anemia, failure-to-thrive in children, and decreased bone density. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by heterogeneous clinical manifestations, which may also involve the gastrointestinal tract. Comorbidity of CD and SLE is rare, and the overlapping symptoms and nonspecific clinical presentation may pose a diagnostic challenge to clinicians. We report here a case of SLE with CD, which mainly manifested as recurrent diarrhea, uncorrectable electrolyte disorders, and severe malnutrition. Through review, we hope to further improve our understanding and diagnostic level of this combination of diseases.


Assuntos
Doenças Autoimunes , Doença Celíaca , Lúpus Eritematoso Sistêmico , Autoanticorpos , Doença Celíaca/complicações , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Criança , Comorbidade , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/epidemiologia
5.
World J Gastroenterol ; 27(19): 2251-2256, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34040319

RESUMO

Celiac Disease (CD) had been considered uncommon in Asia for a long time. However, several studies suggested that, in the Indian subcontinent and Middle East countries, CD is present and as prevalent as in Western countries. Outside these Asian regions, the information about the epidemiology of CD is still lacking or largely incomplete for different and variable reasons. Here, we discuss the epidemiological aspects and the diagnostic barriers in several Asian regions including China, Japan, Southeast Asia and Russia/Central Asia. In some of those regions, especially Russia and Central Asia, the prevalence of CD is very likely to be underestimated. Several factors may, to a different extent, contribute to CD underdiagnosis (and, thus, underestimation of its epidemiological burden), including the poor disease awareness among physicians and/or patients, limited access to diagnostic resources, inappropriate use or interpretation of the serological tests, absence of standardized diagnostic and endoscopic protocols, and insufficient expertise in histopathological interpretation.


Assuntos
Doença Celíaca , Ásia/epidemiologia , Ásia Sudeste , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , China/epidemiologia , Humanos , Japão , Oriente Médio/epidemiologia , Prevalência , Federação Russa
6.
World J Gastroenterol ; 27(13): 1311-1320, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33833484

RESUMO

BACKGROUND: Non-responsive celiac disease (NRCD) is defined as the persistence of symptoms in individuals with celiac disease (CeD) despite being on a gluten-free diet (GFD). There is scant literature about NRCD in the pediatric population. AIM: To determine the incidence, clinical characteristics and underlying causes of NRCD in children. METHODS: Retrospective cohort study performed at Boston Children's Hospital (BCH). Children < 18 years diagnosed with CeD by positive serology and duodenal biopsies compatible with Marsh III histology between 2008 and 2012 were identified in the BCH's Celiac Disease Program database. Medical records were longitudinally reviewed from the time of diagnosis through September 2015. NRCD was defined as persistent symptoms at 6 mo after the initiation of a GFD and causes of NRCD as well as symptom evolution were detailed. The children without symptoms at 6 mo (responders) were compared with the NRCD group. Additionally, presenting signs and symptoms at the time of diagnosis of CeD among the responders and NRCD patients were collected and compared to identify any potential predictors for NRCD at 6 mo of GFD therapy. RESULTS: Six hundred and sixteen children were included. Ninety-one (15%) met criteria for NRCD. Most were female (77%). Abdominal pain [odds ratio (OR) 1.8 95% confidence interval (CI) 1.1-2.9], constipation (OR 3.1 95%CI 1.9-4.9) and absence of abdominal distension (OR for abdominal distension 0.4 95%CI 0.1-0.98) at diagnosis were associated with NRCD. NRCD was attributed to a wide variety of diagnoses with gluten exposure (30%) and constipation (20%) being the most common causes. Other causes for NRCD included lactose intolerance (9%), gastroesophageal reflux (8%), functional abdominal pain (7%), irritable bowel syndrome (3%), depression/anxiety (3%), eosinophilic esophagitis (2%), food allergy (1%), eating disorder (1%), gastric ulcer with Helicobacter pylori (1%), lymphocytic colitis (1%), aerophagia (1%) and undetermined (13%). 64% of children with NRCD improved on follow-up. CONCLUSION: NRCD after ≥ 6 mo GFD is frequent among children, especially females, and is associated with initial presenting symptoms of constipation and/or abdominal pain. Gluten exposure is the most frequent cause.


Assuntos
Doença Celíaca , Dieta Livre de Glúten , Boston , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Criança , Feminino , Glutens , Humanos , Masculino , Estudos Retrospectivos
7.
BMC Gastroenterol ; 21(1): 159, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33836647

RESUMO

BACKGROUND: Living with undiagnosed symptomatic coeliac disease is connected with deteriorated health, and persons with coeliac disease often wait a long time for their diagnosis. A mass screening would lower the delay, but its cost-effectiveness is still unclear. Our aim was to determine the cost-effectiveness of a coeliac disease mass screening at 12 years of age, taking a life course perspective on future benefits and drawbacks. METHODS: The cost-effectiveness was derived as cost per quality-adjusted life-year (QALY) using a Markov model. As a basis for our assumptions, we mainly used information from the Exploring the Iceberg of Celiacs in Sweden (ETICS) study, a school-based screening conducted in 2005/2006 and 2009/2010, where 13,279 12-year-old children participated and 240 were diagnosed with coeliac disease, and a study involving members of the Swedish Coeliac Association with 1031 adult participants. RESULTS: The cost for coeliac disease screening was 40,105 Euro per gained QALY. Sensitivity analyses support screening based on high compliance to a gluten-free diet, rapid progression from symptom-free coeliac disease to coeliac disease with symptoms, long delay from celiac disease with symptoms to diagnosis, and a low QALY score for undiagnosed coeliac disease cases. CONCLUSIONS: A coeliac disease mass screening is cost-effective based on the commonly used threshold of 50,000 Euro per gained QALY. However, this is based on many assumptions, especially regarding the natural history of coeliac disease and the effects on long-term health for individuals with coeliac disease still eating gluten.


Assuntos
Doença Celíaca , Adulto , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Criança , Análise Custo-Benefício , Dieta Livre de Glúten , Humanos , Programas de Rastreamento , Anos de Vida Ajustados por Qualidade de Vida , Suécia/epidemiologia
10.
Ann Afr Med ; 20(1): 19-23, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33727507

RESUMO

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder caused by pancreatic ß-cells destruction. Anti-pancreatic antibodies are the witness of ß-cell destruction and their dosage is mainly used for etiological diagnosis. Patients with T1DM are at increased risk of developing other autoimmune reactions, which may involve other organs, resulting in organ specific autoimmune disease. The most frequently encountered are autoimmune thyroid disease, followed by celiac and gastric disease and other rare autoimmune diseases. Objectives: The purpose of this study is to investigate the prevalence of autoimmune markers in patients with T1DM. Methods: The study was conducted at the Department of Endocrinology of the Military Hospital Moulay Ismail in Meknes Morocco, from January 2016 to December 2018. All Type 1 diabetes patients consulting during the study period were included in the study. Their clinical and biochemical data were collected at their first presentation, made up of anti-pancreatic antibodies (glutamic acid decarboxylase [GAD] antibody, tyrosine phosphatase antibody, and islet cell antibody) and other organ-specific antibodies: the thyroid (antithyroid peroxidase antibody, antithyroglobulin antibody, and antithyroid-stimulating hormone receptor antibody), the intestine (IgA antitissue transglutaminase antibody), the adrenal gland (anti-21 hydroxylase antibody), and the stomach (antigastric parietal cell antibody and anti-intrinsic factor antibody). Results: Fifty-four patients were included, with an average age of 26 years. GAD, tyrosine phosphatase, and islet cell antibodies were detected in 74%, 22%, and 3.7%, respectively, of the 54 patients examined. The prevalence of extrapancreatic autoimmunity was 45% with a large preponderance among different immunities of those from thyroid and celiac diseases (CDs). Conclusion: Our results confirm that patients with Type 1 diabetes should be investigated for the presence of autoimmune diseases mainly from thyroid and CDs.


Assuntos
Autoanticorpos/sangue , Doença Celíaca/imunologia , Diabetes Mellitus Tipo 1/imunologia , Tireoidite Autoimune/imunologia , Adulto , Autoimunidade , Doença Celíaca/complicações , Doença Celíaca/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Glutamato Descarboxilase/sangue , Glutamato Descarboxilase/imunologia , Humanos , Imunoglobulinas Glândula Tireoide-Estimulantes/sangue , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prevalência , Tireoidite Autoimune/complicações , Tireoidite Autoimune/epidemiologia , Adulto Jovem
11.
Clin Med (Lond) ; 21(2): 127-130, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33762372

RESUMO

Coeliac disease (CD) is a common autoimmune-mediated gluten sensitive enteropathy, with a prevalence of around 1%. While the incidence of CD has increased over the last 2 decades, many cases still remain undiagnosed. The presentation of CD is variable and can be subtle, with it being important to explore both gastrointestinal and extra-intestinal features. The cornerstone of management is adherence to a strict gluten free diet, which requires support and education from an expert gastrointestinal dietitian. Persisting symptoms in individuals requires re-evaluation, with repeat duodenal biopsies sometimes required. Refractory CD affects a small subset of individuals with CD, requiring specialist input.


Assuntos
Doença Celíaca , Biópsia , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Doença Celíaca/terapia , Dieta Livre de Glúten , Inglaterra/epidemiologia , Humanos , Medicina Estatal
12.
BMC Gastroenterol ; 21(1): 99, 2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33663388

RESUMO

BACKGROUND: Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients' quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. METHODS: The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. RESULTS: The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. CONCLUSIONS: Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients' quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.


Assuntos
Doença Celíaca , Qualidade de Vida , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Criança , Humanos , Polônia/epidemiologia , Inquéritos e Questionários , Reino Unido/epidemiologia
13.
Soc Work Health Care ; 60(2): 187-196, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33775233

RESUMO

COVID-19 has led to high rates of food insecurity. Food insecure patients with food allergy and celiac disease are especially vulnerable during the pandemic when foods become limited. This paper describes a practice innovation implemented by a community-based organization, Food Equality Initiative (FEI), whose mission is improving health and ending hunger among individuals with food allergy and celiac disease. FEI responded to the pandemic by converting their in-person pantries to a contactless delivery of safe foods. The practice innovation is discussed in relation to three system-level elements necessary to sustain the integration of social care into the delivery of healthcare.


Assuntos
COVID-19/epidemiologia , Doença Celíaca/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Insegurança Alimentar , Serviço Social/organização & administração , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2 , Estados Unidos/epidemiologia
14.
BMC Pediatr ; 21(1): 147, 2021 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-33781226

RESUMO

BACKGROUND: Celiac Disease (CD) is an autoimmune systemic disorder triggered by gluten in genetically susceptible individuals, which can lead to chronic malabsorption. Considering the changes in the manifestations of CD, this study aimed to determine anthropometric indices and clinical indications in children with CD. METHODS: This cross-sectional study aimed to evaluate the children with CD who had referred to Imam Reza Celiac Clinic between 2016 and 2019. Totally, 361 children were eligible and their anti-tissue transglutaminase (TGA-IgA) level, weight, height, and Body Mass Index (BMI) were extracted from their records. The anthropometric indices were presented based on the criteria of the Center for Disease Control and Prevention (CDC) and World Health Organization (WHO). The prevalent symptoms were assessed, as well. RESULTS: Based on the CDC's criteria, 18.3, 28.8, and 25.8% of the children had short stature, low body weight, and low BMI, respectively. These measures were obtained as 10, 22.4, and 13.9% according to the WHO's categorization respectively. Furthermore, the most common symptoms among the children were abdominal pain (56.5%), skeletal pain (28%), constipation (27.4%), and anemia (23.8%). CONCLUSION: To sum up, the results clearly indicated that growth failure and low height, weight, and BMI were prevalent among the children with CD. Moreover, in addition to gastrointestinal symptoms, a considerable number of patients had skeletal pain and anemia.


Assuntos
Doença Celíaca , Desnutrição , Peso Corporal , Doença Celíaca/complicações , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Criança , Estudos Transversais , Dieta Livre de Glúten , Humanos , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/etiologia
15.
Mayo Clin Proc ; 96(3): 666-676, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33673917

RESUMO

OBJECTIVE: To assess the prevalence of atherosclerotic cardiovascular disease (ASCVD) by age and sex in patients with celiac disease and to determine associations between ASCVD and celiac disease. PATIENTS AND METHODS: This is a retrospective cohort study which included adults (>18 years old) who had hospitalizations recorded in the National Inpatient Sample database in the United States from January 1, 2005, to December 31, 2014. Patients with celiac disease were matched (1:5) by age, sex, race, and calendar year to patients without celiac disease. Prevalence of ASCVD was calculated in patients with celiac disease and controls, and compared by sex and age groups. Associations between celiac disease and ASCVD were determined after adjustment for common cardiovascular risk factors. RESULTS: Among 371,776,860 patients hospitalized in the United States between 2005 and 2014, 227,172 adults with celiac disease were matched to 1,133,701 controls. Young women with celiac disease (age <40 years) had a higher prevalence of ASCVD and higher adjusted odds (aOR) of ASCVD when compared with controls (aged 18 to 29 years aOR, 2.22 [95% CI 1.41 to 3.5]; P<.001; and aged 30 to 39 years aOR 1.54 [95% CI 1.19 to 1.99]; P<.001). Adults with celiac disease of all ages and sexes had increased adjusted odds of death if they had ASCVD (aOR aged <40 years 7.31 [95% CI 2.49 to 21.46]; P<.001; and aOR aged ≥40 years 2.02 [95% CI 1.68 to 2.42]; P<.001). CONCLUSION: We found significantly higher prevalence and adjusted odds of ASCVD in young women with celiac disease when compared with matched controls. ASCVD was associated with significant mortality among patients with celiac disease.


Assuntos
Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Doença Celíaca/epidemiologia , Nível de Saúde , Adulto , Estudos de Casos e Controles , Doença Celíaca/complicações , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia , Adulto Jovem
16.
Nutrients ; 13(2)2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33540585

RESUMO

We aimed to assess Health-Related Quality of Life (HRQoL) of Italian children and their parents with coeliac disease (CD) using the Coeliac Disease Dutch Questionnaire (CDDUX). The CDDUX underwent a cross-cultural adaptation in a multi-step process, according to international guidelines. A total of 224 children aged between 8-18 years and their parents were prospectively recruited. Cronbach α coefficient was determined as a measure of internal consistency of the questionnaire and inter-children/parent reliability by intraclass correlation coefficient. Univariate and bivariate regression models were used to evaluate correlations between clinical variables and children and parents subclasses of CDDUX and overall mean Paediatric Quality of Life Inventory (PedsQL). The Italian CDDUX proved to be valid and reliable, mean CDDUX total score revealing a neutral evaluation of the quality of life in children 52.6 ± 17.2 and parents 49.5 ± 17.9 (p = 0.07) with strong correlation with PedsQL. The only clinical variable which appeared to affect significantly quality of life both in children and parents was the lower age. A comparison with our results showed remarkable differences in the HRQoL of populations of various nationalities. The Italian version of the CDDUX questionnaire is a simple and reliable tool for assessing the HRQoL in children and adolescents with CD.


Assuntos
Doença Celíaca , Qualidade de Vida , Inquéritos e Questionários , Adolescente , Doença Celíaca/epidemiologia , Doença Celíaca/fisiopatologia , Doença Celíaca/psicologia , Criança , Comorbidade , Dieta Livre de Glúten , Feminino , Humanos , Itália , Masculino , Países Baixos , Pais , Psicometria , Reprodutibilidade dos Testes
18.
BMC Gastroenterol ; 21(1): 90, 2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33639838

RESUMO

BACKGROUND: Studies have indicated that underdiagnosis and diagnostic delay are common in celiac disease. Therefore, it is important to increase our knowledge of what symptoms and biomarkers could identify undiagnosed cases of celiac disease. METHODS: We screened for celiac disease antibodies in stored blood samples from 16,776 participants in eight population-based studies examined during 1976-2012. Undiagnosed celiac seropositivity was defined as celiac disease antibody positivity (IgG-deamidated gliadin peptide above 10.0 U/mL and/or IgA-tissue transglutaminase (TTG) or IgG-TTG above 7.0 U/mL) without a known diagnosis of celiac disease in the National Patient Register. In all studies general health symptoms were recorded by participant-completed questionnaire, including self-perceived health, tiredness, headache and gastrointestinal symptoms. Furthermore, blood samples were drawn for analyses of biomarkers e.g. hemoglobin, blood glucose, cholesterol, liver parameters and vitamins. The participants with undiagnosed celiac seropositivity were matched by sex, age and study with four controls among the celiac disease antibody negative participants. RESULTS: We excluded, five participants with known celiac disease, resulting in a population of 16,771 participants. In this population 1% (169/16,771) had undiagnosed celiac seropositivity. There were no statistically significant differences in symptoms between cases and controls. Undiagnosed celiac seropositivity was associated with low blood cholesterol (< 5 mmol/L) and low hemoglobin (< 7.3 mmol/L for women and < 8.3 mmol/L for men). CONCLUSION: In this general population study, undiagnosed cases of celiac seropositivity did not have more symptoms than controls, confirming the diagnostic difficulties of celiac disease and the low prognostic value of symptoms for a diagnosis of celiac disease. Furthermore, decreased levels of cholesterol and/or hemoglobin in the blood were associated with undiagnosed celiac seropositivity.


Assuntos
Doença Celíaca , Diagnóstico Tardio , Autoanticorpos , Biomarcadores , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Feminino , Gliadina , Humanos , Imunoglobulina A , Imunoglobulina G , Masculino , Transglutaminases
20.
Aliment Pharmacol Ther ; 53(6): 696-703, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33547687

RESUMO

BACKGROUND: Incidence rate and temporal trends in coeliac disease and coeliac disease autoimmunity incidence vary worldwide with most data available from North American and European countries. AIMS: To explore temporal trends in incidence of coeliac disease autoimmunity and their relation to increase in screening tests in Israel. METHODS: A large retrospective population-based study was conducted in Maccabi Healthcare Services, a 2.3-million-member health maintenance organisation operating in Israel. The cohort included all patients with newly diagnosed coeliac disease autoimmunity based on first positive anti-tissue transglutaminase type 2 IgA antibodies. Data were analysed for the years 2007-2015. RESULTS: During the study period (17.3 million person-years), a total of 403 283 patients were tested for coeliac disease autoimmunity, of whom 6444 were positive, representing an average incidence rate of 36.64 per 100 000 person-years (95% CI: 35.74-37.55). Incidence of coeliac disease autoimmunity increased from 25.4 per 100 000 in 2007 to 52.3 per 100 000 person-years in 2015 (Incidence rate ratio of 2.06, 95% CI 1.81-2.26). Coeliac disease autoimmunity incidence was highest in the paediatric age groups, especially in children aged 0-5, and was 4 times higher than the incidence in adults aged 26-55 (Incidence rate ratio of 0.24, 95% CI (0.22-0.26). The increase in incidence surpassed the increase in testing for new patients. Positive trends in incidence were highest in small children, whereas the incidence in adults was stable over the years. CONCLUSIONS: There was a steady increase in coeliac disease autoimmunity incidence in our cohort between the years 2007-2015. The paediatric population was the only contributor to this trend.


Assuntos
Doença Celíaca , Adulto , Autoimunidade , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Criança , Pré-Escolar , Europa (Continente) , Humanos , Incidência , Lactente , Recém-Nascido , Israel/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Transglutaminases
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