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Screening of celiac disease in children with Henoch-Schoenlein purpura

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Abstract

Prevalence of celiac disease (CD) is 2.42 % in healthy Turkish children. The frequency of IgA-associated disorders is increased in CD. Henoch-Schoenlein purpura (HSP) is an IgA-associated vasculitis. Association of HSP with CD has not been evaluated. We aimed to evaluate whether CD prevalence is increased in children with HSP. Children with HSP were evaluated for demographic, anthropometric, clinical, and laboratory data including urinalysis, complete blood count, albumin, creatinine, and IgA levels. In addition, tTG-IgA, EMA-IgA, anti-DGP-IgA, and IgG antibody levels were measured. Seropositive patients were evaluated by endoscopic small bowel biopsy. The rate of CD seropositivity and confirmed CD in HSP patients was compared to the rate in healthy Turkish children. There were 42 children (25 male) with HSP. No patient had classical CD symptoms, but two patients had growth failure. None of them had IgA deficiency, anemia or hypoalbuminemia. Celiac serology was positive in five (12 %) children. Endoscopic evaluation was performed in four patients, and two (5 %) of them were confirmed to have CD. Prevalence of both CD seropositivity and histologically confirmed CD in children with HSP was significantly higher compared to healthy Turkish children (p < 0.001 and p = 0.019, respectively). CD seropositivity rate in children with HSP (12 %) is significantly higher than the rate in healthy children. Although the number of children with HSP is small in this preliminary study, this result suggests that celiac screening may be considered in children with HSP.

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Abbreviations

CD:

Celiac disease

DGP-IgA:

Anti-deaminated gliadin peptide IgA

DGP-IgG:

Anti-deaminated gliadin peptide IgG

EMA-IgA:

Anti-endomysium IgA

HSP:

Henoch-Schoenlein purpura

IgAN:

Immunoglobulin A nephropathy

KD:

Kawasaki disease

tTG-IgA:

Anti-tissue transglutaminase IgA

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Author contributions

Dr. Alper Soylu conceptualized and designed the study, and drafted the initial manuscript. Dr. Yeşim Öztürk performed endoscopic evaluation of seropositive patients. Drs. Yavuz Doğan and Özlem Yılmaz carried out the laboratory analyses for celiac disease screening. Drs. Derya Özmen and Pınar Kayum evaluated the hospital files of the patients to collect clinical and laboratory data, and performed statistical analyses. Dr. Salih Kavukçu critically reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, Dokuz Eylül University Medical Faculty, 35340, Balcova, Izmir, Turkey

    Alper Soylu, Yeşim Öztürk, Derya Özmen, Pınar Kuyum & Salih Kavukçu

  2. Department of Microbiology, Dokuz Eylül University Medical Faculty, Izmir, Turkey

    Yavuz Doğan & Özlem Yılmaz

Authors
  1. Alper Soylu
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  2. Yeşim Öztürk
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  3. Yavuz Doğan
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  4. Derya Özmen
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  5. Özlem Yılmaz
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  6. Pınar Kuyum
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  7. Salih Kavukçu
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Correspondence to Alper Soylu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Soylu, A., Öztürk, Y., Doğan, Y. et al. Screening of celiac disease in children with Henoch-Schoenlein purpura. Rheumatol Int 36, 713–717 (2016). https://doi.org/10.1007/s00296-016-3425-3

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  • DOI: https://doi.org/10.1007/s00296-016-3425-3

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