Celiac Disease and Autoimmune Diseases in a Pediatric Population: A Cross-Sectional Study

Celiac.com 09/02/2024 - Celiac disease is an autoimmune condition triggered by gluten consumption in genetically predisposed individuals. This disease affects various bodily systems and is diagnosed through a combination of clinical symptoms and laboratory tests. Research indicates that individuals with celiac disease are at a higher risk of developing additional autoimmune diseases. The objective of this study was to determine the prevalence of autoimmune diseases in Moroccan children diagnosed with celiac disease and to identify potential risk factors for the development of these additional conditions.

Study Overview

This study was conducted at the Mohamed VI Hospital and University Center in Oujda, Morocco, over a period of seven years, from January 2017 to January 2024. The researchers collected medical data from pediatric patients under the age of 16 who had been diagnosed with celiac disease. The diagnosis was confirmed through clinical signs and laboratory tests, including the measurement of serum antitissue transglutaminase antibody IgA levels and intestinal mucosal biopsy. The study aimed to identify the prevalence of autoimmune diseases among these patients and to explore any associated risk factors.

Study Results

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The study included 60 pediatric patients diagnosed with celiac disease. Among these patients, eight (13%) also had an associated autoimmune disease. The average age of these children was eight years, ranging from two to 15 years. The majority of these patients (75%) were diagnosed with an autoimmune disease before being diagnosed with celiac disease. Only one patient was diagnosed with both conditions simultaneously, and one was diagnosed with an autoimmune disease after the celiac disease diagnosis. The most common autoimmune diseases observed were type 1 diabetes (in seven cases) and autoimmune thyroiditis (in one case).

Clinical Characteristics

The study found that 65% of the pediatric celiac disease patients were underweight, with a body mass index (BMI) under the fifth percentile for their age. The remaining 35% had a normal BMI. Clinical symptoms were gradually evident in all patients, with the time between the onset of symptoms and the diagnostic consultation ranging from one to 12 months. Gastrointestinal symptoms were present in 63% of the patients at the time of presentation. Additionally, 85% of the patients were anemic, 50% had low ferritin levels, and 67% had vitamin D levels below 30 ng/mL.

Discussion

Celiac disease is a chronic autoimmune disorder that primarily affects the small intestine. It is well-documented that individuals with celiac disease have a higher risk of developing other autoimmune diseases. This study found that 13% of the pediatric patients with celiac disease also had an associated autoimmune disease, with type 1 diabetes being the most prevalent. The study also highlighted the importance of early diagnosis and regular monitoring for autoimmune diseases in children with celiac disease to optimize management and prevent complications.

The study noted that patients with type 1 diabetes are particularly at risk of developing celiac disease due to shared genetic markers. Specifically, around 90% of individuals with type 1 diabetes have the DQ2 or DQ8 genotypes, which are also common in celiac disease patients. The study emphasized the importance of serological screening for celiac disease in children diagnosed with type 1 diabetes.

Conclusion

This study underscores the significant correlation between celiac disease and the development of additional autoimmune diseases in pediatric patients. The findings indicate that children with celiac disease are at an increased risk of developing conditions like type 1 diabetes and autoimmune thyroiditis. The study calls for improved surveillance and early detection strategies to manage these comorbidities effectively.

Implications for Patients and Families

For patients and families dealing with celiac disease, this study highlights the importance of regular medical follow-ups and comprehensive management plans that include screening for other autoimmune diseases. Understanding the potential for additional autoimmune conditions can lead to better health outcomes and a more proactive approach to managing celiac disease and its associated risks. This research provides valuable insights that can help improve the quality of life for children with celiac disease and their families by fostering a better understanding of the disease and its broader health implications.

Read more at: cureus.com