271 Risk factors of autoimmune gastritis in children with celiac disease

Abstract

<h3></h3> The aim was to determine the risk factors of autoimmune gastritis (AG) in children with celiac disease (CD) Materials and methods: We examined 107 children with a histologically verified diagnosis of chronic gastritis (CG) in combination with CD. The first group consisted of 58 children with CG and newly diagnosed CD. The second group included of 49 children with CG, CD who adhering a gluten-free diet for at least 1 year. IgG antibodies to H +/K + ATPase of parietal cells of gastric mucosa -APCA (U/ml) and IgG antibodies to Castle’s intrinsic factor (U/ml) were determined by the enzyme-linked immunosorbent assay. We performed multivariate correlation and regression analysis, using IBM SPSS Statistics 3 software package. <h3>Results</h3> AG was diagnosed in children only in group 1 – 12,1%, in group 2nd AG wasn’t detected – 0,0% (p&lt;0,01). Multivariate correlation and regression analysis made it possible to identify a number of significant factors and criteria for AG in children with CD: the presence of symptoms of CD for 3 or more years before the diagnosis (r=0,262; p&lt;0,05); concomitant autoimmune thyroiditis (r=0,390; p&lt;0,001); concomitant type 1 diabetes mellitus (r=0,390; p&lt;0,001); family autoimmune pathology history (r=0,298; p&lt;0,05); epigastric pain on palpation (r=0,364; p&lt;0,001); the presence of dyspeptic complaints (r=0,417; p&lt;0,001) and fasting abdominal pain (r 0,336; p&lt;0,01); white coating of the tongue (r=0,349; p&lt;0,01); goitre (r = 0,422 p&lt;0,001); severe lymphocytic infiltration of gastric mucosa (r=0,289; p&lt;0,05), focal destruction of the gastric glands (r=0,698; p&lt;0,001); atrophy of the gastric glands (r=0,573; p&lt;0,001), neutrophilic infiltration in the fundus of the stomach (r=0,44;1 p&lt;0,001); the presence of atrophy of the glands (r=0,441; p&lt;0,001) and fibrosis of the stroma ( =0,296; p&lt;0,05) of the antrum; the small intestine atrophy according to Marsh ≥2 grade (r=0,291; p&lt;0,05) and the presence of the HLA-DQ8 haplotype (r=0,588; p&lt;0,01). Simple logistic regression equation revealed a high likelihood of AG in patients with CD, who has 9 and more described factors. Visual assessment by the ROC-curve of the obtained mathematical model presented significant predictive ability (area under the curve=0,987). Conclusion detection of the revealed risk factors promotes early diagnosis of AG in children with CD.