Poddighe Dimitri, Romano Micol, Dossybayeva Kuanysh, Abdukhakimova Diyora, Galiyeva Dinara, Demirkaya Erkan
Department of Medicine, Nazarbayev University School of Medicine (NUSOM), Nur-Sultan 010000, Kazakhstan.
Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health (NRCMCH), University Medical Center (UMC), Nur-Sultan 010000, Kazakhstan.
J Clin Med. 2022 Feb 18;11(4):1089. doi: 10.3390/jcm11041089.
Celiac Disease (CD) is an immune-mediated and gluten-related disorder whose prevalence is higher in children affected with other autoimmune disorders, including diabetes mellitus type 1, autoimmune thyroiditis, and others. As regards Juvenile Idiopathic Arthritis (JIA) and other pediatric rheumatic disorders, there is no clear recommendation for CD serological screening. In this review, we analyze all the available clinical studies investigating CD among children with JIA (and other rheumatic diseases), in order to provide objective data to better understand the necessity of CD serological screening during the follow-up. Based on the present literature review and analysis, >2.5% patients with JIA were diagnosed with CD; however, the CD prevalence in JIA patients may be even higher (>3-3.5%) due to several study limitations that could have underestimated CD diagnosis to a variable extent. Therefore, serological screening for CD in children affected with JIA could be recommended due to the increased CD prevalence in these patients (compared to the general pediatric population), and because these JIA patients diagnosed with CD were mostly asymptomatic. However, further research is needed to establish a cost-effective approach in terms of CD screening frequency and modalities during the follow-up for JIA patients. Conversely, at the moment, there is no evidence supporting a periodical CD screening in children affected with other rheumatic diseases (including pediatric systemic lupus erythematosus, juvenile dermatomyositis, and systemic sclerosis).
乳糜泻（CD）是一种免疫介导的与麸质相关的疾病，在患有其他自身免疫性疾病的儿童中患病率更高，这些疾病包括1型糖尿病、自身免疫性甲状腺炎等。至于幼年特发性关节炎（JIA）和其他儿童风湿性疾病，对于CD血清学筛查尚无明确建议。在本综述中，我们分析了所有调查JIA（及其他风湿性疾病）患儿中CD情况的现有临床研究，以便提供客观数据，更好地了解随访期间进行CD血清学筛查的必要性。基于目前的文献综述和分析，>2.5%的JIA患者被诊断为CD；然而，由于一些研究局限性可能在不同程度上低估了CD诊断，JIA患者中CD的患病率可能更高（>3-3.5%）。因此，鉴于这些患者（与一般儿科人群相比）中CD患病率增加，且这些被诊断为CD的JIA患者大多无症状，可建议对患有JIA的儿童进行CD血清学筛查。然而，需要进一步研究以确定在JIA患者随访期间进行CD筛查的频率和方式方面具有成本效益的方法。相反，目前没有证据支持对患有其他风湿性疾病（包括儿童系统性红斑狼疮、幼年皮肌炎和系统性硬化症）的儿童进行定期CD筛查。
