难治性癫痫患儿乳糜泻的临床及辅助检查筛查
Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy.
作者信息
Ghazizadeh Esslami Golnaz, Allahverdi Bahar, Badv Reza Shervin, Heidari Morteza, Khosroshahi Nahid, Shabani-Mirzaee Hosein, Eftekhari Kambiz
机构信息
Department of Pediatrics, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Pediatric Gastroenterology and Hepatology Research Center, Children's Medical Center, The Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Neurol Res Int. 2021 Apr 22;2021:1639745. doi: 10.1155/2021/1639745. eCollection 2021.
BACKGROUND
Celiac disease is the inflammatory entropy caused by hypersensitivity to gluten, which occurs in susceptible individuals. Some studies have suggested a link between celiac disease and epilepsy in children. Our aim was to screen for clinical and paraclinical features of celiac disease in children with intractable epilepsy.
METHODS
This was a cross-sectional study. Children aged 2 to 18 years with refractory epilepsy that referred to the pediatric neurology clinic within one year (2018-2019) were enrolled. Demographic and clinical characteristics of patients, especially clinical manifestations of celiac disease, were recorded in a questionnaire. A venous blood sample was sent to determine the total IgA, anti-tTG (IgA), and anti-endomysial antibody (IgA). Endoscopy was performed in cases where the celiac serological test was positive.
RESULTS
Seventy children with idiopathic drug-resistant epilepsy (44 boys) were evaluated. The height-for-age index was 49.2% and the weight-for-age index was 38.2% less than normal. Constipation (48.6%), anorexia (25.7%), and abdominal pain (21.4%) were the most common gastrointestinal symptoms. Celiac serological tests were negative in all children. Therefore, endoscopy and bowel biopsy were not performed in any case.
CONCLUSION
Celiac disease was not found in any patient with intractable epilepsy. Gastrointestinal symptoms and growth disorders in this group may be related to the underlying disease or medications and not to celiac disease.
背景
乳糜泻是由对面筋过敏引起的炎症性疾病，发生于易感个体。一些研究表明儿童乳糜泻与癫痫之间存在关联。我们的目的是筛查难治性癫痫患儿中乳糜泻的临床和辅助检查特征。
方法
这是一项横断面研究。纳入2018 - 2019年一年内转诊至儿科神经科门诊的2至18岁难治性癫痫患儿。通过问卷记录患者的人口统计学和临床特征，尤其是乳糜泻的临床表现。采集静脉血样本测定总IgA、抗组织转谷氨酰胺酶抗体（IgA）和抗肌内膜抗体（IgA）。乳糜泻血清学检测呈阳性的病例进行内镜检查。
结果
对70例特发性耐药癫痫患儿（44例男孩）进行了评估。年龄别身高指数比正常低49.2%，年龄别体重指数比正常低38.2%。便秘（48.6%）、厌食（25.7%）和腹痛（21.4%）是最常见的胃肠道症状。所有患儿的乳糜泻血清学检测均为阴性。因此，所有病例均未进行内镜检查和肠道活检。
结论
在任何难治性癫痫患者中均未发现乳糜泻。该组患儿的胃肠道症状和生长障碍可能与基础疾病或药物有关，而非与乳糜泻有关。
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