Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Miami Miller School of Medicine, Miami, FL.
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):542-545. doi: 10.1097/MPG.0000000000002993.
Functional abdominal pain disorders (FAPDs) are among the most common causes of consultation in general pediatrics and pediatric gastroenterology. The Rome IV criteria recommend testing for celiac disease (CD) in children with irritable bowel syndrome-diarrhea (IBS-D) and leaves testing in cases of other FAPDs to the practitioner's discretion. These recommendations were based on a single study that showed a 4-fold increase of CD among patients with IBS in Italy. It is unclear if these findings can be extrapolated to other populations. Understanding whether those results are reproducible in areas with different racial/ethnic backgrounds can optimize patient care.
The aim of the study was to assess the prevalence of CD in a sample of children consulting for FAPDs to a tertiary care center in Miami.
The charts of all pediatric patients consulting for FAPDs from January 2016 to November 2019 at the University of Miami were reviewed. Demographics, diagnosis, and CD testing for each child were analyzed.
One hundred eighty-one children with FAPDs and celiac testing were seen. Mean age of 12.89 years, girls 61.34%. 84 (46.40%) had a diagnosis of IBS and 97 (53.59%) had a diagnosis of other FAPD. One of 181 children with FAPDs (0/84 with IBS and 1/97 with other FAPDs) had positive CD serological testing and EGD confirmation.
Our study suggests that the prevalence of CD among children with FAPDs is similar to the community prevalence. This data questions the benefit of testing all children FAPDS (including IBS) for CD. Studies with larger sample size and various racial/ethnic makeup should be done to confirm our findings.
功能性腹痛障碍（FAPDs）是普通儿科和儿科胃肠病学中最常见的就诊原因之一。罗马 IV 标准建议对腹泻型肠易激综合征（IBS-D）患儿进行乳糜泻（CD）检测，而其他 FAPD 患儿的检测则由医生自行决定。这些建议是基于一项研究得出的，该研究表明意大利 IBS 患者中 CD 的发病率增加了 4 倍。目前尚不清楚这些发现是否可以推广到其他人群。了解这些结果在不同种族/民族背景的地区是否具有重现性，可以优化患者的治疗。
本研究旨在评估在迈阿密一家三级保健中心就诊的 FAPD 患儿中 CD 的患病率。
回顾了 2016 年 1 月至 2019 年 11 月期间在迈阿密大学因 FAPDs 就诊的所有儿科患者的病历。分析了每位患儿的人口统计学、诊断和 CD 检测结果。
共 181 例 FAPDs 患儿接受了 CD 检测。患儿的平均年龄为 12.89 岁，女孩占 61.34%。84 例（46.40%）诊断为 IBS，97 例（53.59%）诊断为其他 FAPD。在 181 例 FAPDs 患儿中，有 1 例（84 例 IBS 患儿中无 1 例，97 例其他 FAPD 患儿中 1 例）出现 CD 血清学检测和 EGD 证实阳性。
本研究表明，FAPDs 患儿的 CD 患病率与社区患病率相似。这些数据对所有 FAPDs（包括 IBS）患儿进行 CD 检测的益处提出了质疑。应该进行更大规模的样本量和各种种族/民族构成的研究，以证实我们的发现。
