A single-centre, tertiary-care, Italian registry of celiac disease: Incidence and clinical presentation

Abstract

s / Digestive and Liver Disease 46 (2014) e85–e127 e95 4.5±0.6pg/ml, mean FT4 1.2± .4 ng/dl. TSH levels were above cutoff laboratory range in 10% of our population and the 2 patients (0.2%) of the whole population presented TSH≥10 UI/ml. We found a significant positive correlation between TSH levels and BMI z-score (rho=0.121, p=0.001), even after adjustment for age and sex (r=0.117, p=0.001); a positive correlation was also observed between FT3 and BMI z-score (rho=0.161, p<0.001), but not for Ft4 (p=0.787). TSH and FT3 were also positively associated with Waist to Height ratio (WtHr, rho=0.114, p=0.002 and rho=0.095, p=0.011 respectively). No correlation was found between thyroid functionality and: Homa index, z-score of blood pressure and hepatic steatosis. Conclusions: Our data suggest a relationship between obesity and serum TSH and FT3 levels. In particular, WtHr, marker of visceral fat, is directly related to TSH levels. It is not clear whether thyroid alteration are cause or consequence of fat excess, but metabolic active visceral fat could have a role. http://dx.doi.org/10.1016/j.dld.2014.07.078 A SINGLE-CENTRE, TERTIARY-CARE, ITALIAN REGISTRY OF CELIAC DISEASE: INCIDENCE AND CLINICAL PRESENTATION Valentina Giorgio ∗, Maria Rita Sartorelli, Claudia Della Corte, Donatella Comparcola, Daniela Liccardo, Arianna Alterio, Valerio Nobili, Francesca Ferretti Malattie EpatoMetaboliche, Ospedale Pediatrico “Bambino Gesu”, Roma, Italy Objectives: The aim of this study was to assess clinical pattern and the incidence of celiac disease (CD) currently diagnosed in children living in Rome, describing a single-Italian-center experience. Methods: A prospective, single-center registry of new cases of CD in children under 18 years was conducted from 1 January 2011 to 1 June2013. The variables studiedwere: age at diagnosis, gender, breast feeding, clinical symptoms, associated diseases, IgA serum levels, CD serology, histological lesions, and HLA DQ2/QQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births. Results: 800 new cases of CD were included (39% males). The median age at diagnosis was 8 years (range 0.9–18). 483/800 (60%) were breast fed≥2months, with amean breast feeding duration of 15.2±11.4months. Mean age at first gluten exposurewas 6.4±2.2 months. Regarding clinical presentation 68.9% showed classical symptoms, 27.1% were non-classical, and 4% were asymptomatic. Among atypical symptoms, celiac crises was present and seen in 3% of all children. 96.7% were positive for IgA endomysial antibodies, 97.3% were positive for IgA anti-transglutaminase type 2 antibodies. IgA selective deficiency was seen in 4% children. 85,6% performed duodenal biopsy. Villous atrophy was observed in 91% and increased intraepithelial lymphocytes with crypt hyperplasia in 10.3%. 3 children (0.37%) were diagnosed with CD after cutaneous biopsy for dermatitis herpetiformis. The HLA phenotype was performed in 200 children (25%) and was: DQ2: 84.5%, DQ2/DQ8: 5.5% and DQ8: 10%. The incidence rate was 7.08 cases of CD per 1000 live births. Conclusions: InRome, themost frequent clinicalpresentationof CD in the pediatric age is the classical form. The observed incidence of CD in children ismuchhigher than the current CD incidence rates observed in other countries. A multicenter study on larger series would be needed to verify this increasing incidence. http://dx.doi.org/10.1016/j.dld.2014.07.079 EVALUATION OF VITAMIN D STATUS IN A PEDIATRIC POPULATION OF SOUTHERN ITALY Donatella De Giovanni1,∗, Irene Rutigliano1, Clementina Calabrese1, Giovanna Nardella1, Maria Pia Falcone1, Angelo Guida1, Antonio Longo2, Massimo Pettoello-Mantovani1, Angelo Campanozzi1 1 Clinica Pediatrica, Universita’ di Foggia, Foggia, Italy 2 U.O. Pediatria, Ospedali Riuniti di Foggia, Foggia,