Edalatkhah Roohollah, Aflatooninan Majid, Dehghani Firouzabadi Bahareh, Fallah Razieh
Pediatric Gastroentrologist, Assistant Professor, Department of Pediatrics, Children Growth Disorder Research Center, School of Medicine, Shahid Sadoughi General Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran J Child Neurol. 2024 Fall;18(4):61-70. doi: 10.22037/ijcn.v18i1.36844. Epub 2024 Sep 29.
Extra gastrointestinal symptoms in celiac disease (CD), such as neurological manifestations, might be common in pediatrics. The present study aimed to evaluate the frequency of CD in children with idiopathic epilepsy.
MATERIALS & METHODS: In a cross-sectional study, signs and symptoms of CD were evaluated in 40 children aged 2-14 years with idiopathic epilepsy who were referred to the Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran. Then, serum levels of tissue transglutaminase antibody (tTG) and total IgA were measured in them. Upper gastrointestinal endoscopy and small intestine biopsy were recommended for patients with abnormal serum IgA Anti-tTG.
Eighteen girls and 22 boys with a mean age of 5.29±2.4 years were evaluated. In this study, only three patients (7.5%) with epilepsy had abnormal serum IgA Anti-tTG and serum Total IgA. Upper gastrointestinal endoscopy and pathological examination of duodenal biopsy of those three children reported total villous atrophy (Marsh type 3). The age of onset of seizures in children with CD was more than three years, while in children without CD, 62.2% of cases were less than three years. These results indicate that CD is associated with the age of onset of seizures in children.
Due to the accompaniment of celiac with neurological manifestations, patients with neurological symptoms and gastrointestinal symptoms should be examined for celiac.
乳糜泻(CD)的胃肠道外症状,如神经表现,在儿科可能很常见。本研究旨在评估特发性癫痫患儿中CD的发生率。
在一项横断面研究中,对转诊至伊朗亚兹德沙希德萨杜基医科大学儿科神经科门诊的40名2至14岁特发性癫痫患儿的CD体征和症状进行了评估。然后检测了他们的组织转谷氨酰胺酶抗体(tTG)和总IgA血清水平。血清IgA抗tTG异常的患者建议进行上消化道内镜检查和小肠活检。
对18名女孩和22名男孩进行了评估,平均年龄为5.29±2.4岁。在本研究中,只有3例癫痫患者(7.5%)血清IgA抗tTG和血清总IgA异常。这三名儿童的上消化道内镜检查和十二指肠活检病理检查均报告有全绒毛萎缩(马什3型)。CD患儿的癫痫发作起始年龄超过3岁,而无CD患儿中62.2%的病例小于3岁。这些结果表明CD与儿童癫痫发作的起始年龄有关。
由于乳糜泻伴有神经表现,有神经症状和胃肠道症状的患者应检查是否患有乳糜泻。