الأجسام المضادة للإنزيم النسيجى الناقل للجلوتامين كاختبار مسحى لمرض السيليك فى الأطفال قصار القامة

Ain Shams Medicine Pediatrics Master 2007 عبد العليم اسحق رمضان

“Tissue Transglutaminase IgA Antibodies As a Screening Test for Celiac Disease in Short Children

                                                                    “Abd El-Alleem Isak Ramadan

                This study was conducted on 160 children presenting to the Endocrinology clinic children’s hospital – Ain Shams University in the period from September 2005 to August 2006 with a stature of 2SD or more below the mean for age and sex in order to determine the prevalence of celiac disease in children presenting with short stature. All children included were subjected to detailed history taking, full clinical examination, anthropometric evaluation [height, weight, parental height assessment, triceps and subscapular skin fold thickness], plain x-ray of left hand and wrist for bone age assessment, laboratory investigations [hemoglobin concentration, anti-tissue transglutaminase IgA, total IgA]. All screen positive children were subjected to esophagogastrodudenoscopy,           during it duodenal biopsies were taken and sent for histopathological evaluation in Pathology Department to confirm or exclude the diagnosis of celiac disease.

                It was found that the prevalence of celiac disease in short stature children was 1:160 (0.6%). Also, It was found that the commonest cause of short stature was growth hormone deficiency followed by normal variants of growth (familial short stature and constitutional short stature).

                We recommend that any short child should be screened for celiac disease using one of the tests presently used for celiac disease (IgA antitissue transglutaminase antibodies). The total immunoglobulin A count should be determined as well. Patients who are positive for IgA antitissue transglutaminase antibodies or who exhibit IgA deficiency should be referred for an endoscopic intestinal biopsy. Once the diagnosis of celiac disease is confirmed, gluten has to be immediately withdrawn from the diet. Being a developing country, on a cost effective basis, screening should be done only after exclusion of an endocrinal etiology in absence of manifestations of celiac disease.”