HASTANEMİZDE 2005-2019 YILLARI ARASINDA ÇÖLYAK HASTALIĞI TANISI ALAN HASTALARIN EŞLİK EDEN HASTALIKLAR AÇISINDAN VERİLERİNİN DEĞERLENDİRİLMESİ

Abstract

Celiac disease is also known as gluten sensitive enteropathy. Celiac disease is diagnosed with less and less gastrointestinal system complaints and findings. With the increasing clinical variety, diseases accompanying celiac disease have become more recognized. Five hundred six patients (332 females, 174 males) aged between 11 months and 17 years were evaluated in this study, which was conducted to examine the frequency of accompanying diseases in celiac patients. The most obvious complaints of the patients were abdominal pain 169 (33.4%), diarrhea 159 (31.4%), short stature/growth retardation 142 (28.1%), anorexia 130 (25.7%) and pallor 103 (20.3%) . Asymptomatic patients with the silent form (11.8%) screened for first degree relatives of children with CD diagnosis (3.5%), and for patients with type 1 diabetes mellitus (6.1%) in children, Down syndrome (0.4%), Turner syndrome (0.4%), Addison's disease (0.2%), Hashimoto's thyroiditis (0.2%), chronic urticaria (0.2%), recurrent angioedema (0.2%), the diagnosis was made by school screening for three children. The most common findings on physical examination were short stature (105,20.7%), cachectic appearance (86,16.9%), abdominal distension (52,10.2%) and pallor (45,8.8%). Laboratory findings of the patients revealed anemia (32.2%), aspartate aminotransferase (AST) elevation (6.7%), and alanine aminotransferase (ALT) elevation (13.2%). Anti-gliadin antibody (AGA) IgA 75.3% (found/tested) at admission, anti-gliadin antibody (AGA) IgG 74.2% (found/tested), anti-endomysium antibody (EMA) IgA 96.7% (found/tested), tissue transglutaminase 2 antibody IgA 95.4% (found/tested), tissue transglutaminase 2 antibody IgG 46.0% (found/tested) were positive. Of the small intestine biopsies, 47.2% had Marsh type 3b, 38.3% Marsh type 3a, 12.3% Marsh 3c, and 2% Marsh type 2 lesions. Additional findings were found in 92 (18.2%) patients in the histopathological examination of small intestine biopsies. Eighty three patients had gastritis, 15 patients had esophagitis, 2 patients had intestinal metaplasia, 1 patient had hyperplastic polyps in the esophagus. Concomitant disease was present in 32.2% of the patients. Common diseases were endocrinological diseases (16.20%), neurological diseases (3.16%), psychiatric diseases (2.96%), allergic diseases (2.76%), genetic syndromes (2.37%), immunological diseases (2.37%) and autoinflammatory diseases (1.97%). The only currently accepted treatment method for celiac disease is a gluten-free diet, and early treatment will prevent complications. İnvestigations that the effect of removing gluten from the diet in stopping or improving the progression of concomitant diseases continues.