El-Hodhod Mostafa Abdel-Aziz, El-Agouza Iman Ali, Abdel-Al Hala, Kabil Noha Samir, Bayomi Khaled Abd El-Moez
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
ISRN Pediatr. 2012;2012:763783. doi: 10.5402/2012/763783. Epub 2012 Jun 7.
Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia.
背景。乳糜泻（CD）患者可见牙釉质缺陷（DEDs）。本研究旨在检测此类患者中CD的发生率。方法。本研究纳入了140例患有DED的儿童。他们接受了CD检测。对CD患者采用无麸质饮食（GFD）。一组720名年龄和性别匹配的正常儿童作为对照组。对两组进行临床评估。检测血清钙、磷、碱性磷酸酶、血清IgA以及组织转谷氨酰胺酶（tTG）的IgG和IgA类型。结果。与对照组（0.97%）相比，DED患者中CD的诊断率更高（17.86%）（P < 0.0001）。大多数非乳糜泻患者表现为1级DED，而CD患者表现为1级、2级和3级DED。5名儿童乳牙有DED，其余为恒牙。在GFD饮食1年后，与非乳糜泻患者相比，CD患者的DED改善更明显。乳糜泻和非乳糜泻DED患者的胃肠道症状无差异。较低的血清钙显著提示该队列中的CD。结论。DED儿童中CD的患病率高于一般人群。这些DEDs可能是CD的唯一表现；因此，强烈建议在这些患者中进行CD筛查，尤其是在存在体重不足和低钙血症的情况下。
