Clinico-laboratory profile of Seropositive Celiac Diseases in Severe Acute Malnutrition

Pradeep Meena ,Namir Khan ,Mamta Meena ,Priyanka Meena

doi:10.17511/ijpr.2019.i04.02

Abstract

Introduction: Celiac Disease shares clinical features with malnutrition and may be responsible for malnutrition. The objective of this study was to study clinico-laboratory profile of seropositive Celiac Diseases in Severe Acute Malnutrition. Material & Methods: The present study was a prospective, hospital based, observational study conducted at Malnutrition Treatment Centre (MTC) of tertiary care Pediatric hospital associated with government medical college of southern Rajasthan. The study was conducted over the period of one year from Dec. 2017 to Nov. 2018. Total 110 children with Severe Acute Malnutrition enrolled and screened for Celiac Disease on the basis of celiac serology (tTg-IgA/IgG). Clinico-laboratory findings of celiac seropositive and seronegative patients were recorded and analysed statistically. Results: Celiacsero-positivity was observed in 30 cases (27.28%). Out of these seropositive cases 14 cases (46.66%) were seropositive for both tTg-IgA and IgG, while 9 cases (30%) were positive for only tTg-IgA and rest 7 cases (23.33%) were positive for only tTg-IgG. Most of the seropositive patients (12, 40%) were in age group of 4-5 years of age group. In seropositive cases recurrent blood in stool (54.45%) and recurrent diarrhoea (52.94%) were common clinical features at the time of admission. S. Vit. B12 & Folic Acid were low in all the patients but more seropositive patients showed low levels of S. Folic acid (P value <0.05). Conclusions: Recurrent diarrhoea and blood in stool were common presenting feature on admission in celiac seropositive patients suffering from severe acute malnutrition. Vit. B12 and Folic acid deficiency were also observed as a common finding in seropositive patients.

Highlights

Celiac Disease shares clinical features with malnutrition and may be responsible for malnutrition
It is characterized by an enteropathy and lifelong intolerance to gluten initiated by ingestion of gliadin related prolamines from cereals such as wheat, barley and rye in genetically susceptible individual [2]
Study subject: All the children of 1-5 years age group suffering from Severe Acute Malnutrition (SAM) admitted in Malnutrition Treatment Centre

Summary

Introduction

Celiac Disease shares clinical features with malnutrition and may be responsible for malnutrition. The objective of this study was to study clinico-laboratory profile of seropositive Celiac Diseases in Severe Acute Malnutrition. In seropositive cases recurrent blood in stool (54.45%) and recurrent diarrhoea (52.94%) were common clinical features at the time of admission. Conclusions: Recurrent diarrhoea and blood in stool were common presenting feature on admission in celiac seropositive patients suffering from severe acute malnutrition. Vit. B12 and Folic acid deficiency were observed as a common finding in seropositive patients. Celiac Disease is a common cause of mal-absorption in the children and adults. It is characterized by an enteropathy and lifelong intolerance to gluten initiated by ingestion of gliadin related prolamines from cereals such as wheat, barley and rye in genetically susceptible individual [2]. The intolerance to gluten results in immune-mediated damage to the mucosa of the small intestine characteristically inducing villous atrophy and crypt hyperplasia that resolve with the removal of gluten from the diet [1].

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