Abstract
Introduction: The purpose of this study is evaluation of concordance of histologic and endoscopic findings in pediatrics referred to Imam Hossein children’s hospital, in Isfahan for evaluation of celiac disease. An accurate prediction of the likelihood of a histologic finding in the setting of a visually normal endoscopy can help prepare families for unanticipated results. Patients and Methods: This is a retrospective study conducted from 2015-2017. The sampling method is census and all eligible patients are included in the study. At the beginning of the work, obtaining consent for entering the project has been done through interviews. After that, patients information such as file number, age and gender according to the file were entered into the data gathering sheet. Data were analyzed using SPSS software version 22. Pvalue< 0.05 was considered significant. Results: Around 530 patients suspected of having celiac disease participated in the present study. The mean age of the subjects was 6.88 ± 4.31 years. Among them, 57.6% (305 patients) were girls and 42.4% (225 patients) were boys. According to the results, the kappa agreement coefficient is equal to 0.42. There was moderate agreement between endoscopy and pathology findings (kappa = 0.42). Conclusion: The results of the study and the kappa Cohen coefficient indicate the appropriateness of using endoscopy in patients with suspected celiac disease.
Highlights
The purpose of this study is evaluation of concordance of histologic and endoscopic findings in pediatrics referred to Imam Hossein children’s hospital, in Isfahan for evaluation of celiac disease
Celiac disease is detected by an inflammatory consequence, primarily in the upper small intestine, with aspects of infiltration of the lamina propria and beneath the epithelial cells which results in chronic inflammatory condition and progressive villous atrophy [1,2]
The task of serology is becoming more and more crucial, regarding the guidelines of European Society of Pediatric Gastroenterology, Hepatology, and Nutrition, the identification of celiac disease can be conducted without histology in a group of patients with particular conditions like children, high titers of antitissue transglutaminase antibodies, presence of human leukocyte antigen-DQ2, and the positivity of anti-endomysial antibodies [3]
Summary
The purpose of this study is evaluation of concordance of histologic and endoscopic findings in pediatrics referred to Imam Hossein children’s hospital, in Isfahan for evaluation of celiac disease. Results: Around 530 patients suspected of having celiac disease participated in the present study. Conclusion: The results of the study and the kappa Cohen coefficient indicate the appropriateness of using endoscopy in patients with suspected celiac disease. Celiac disease is an autoimmune disease, in genetically predisposed people, by the ingestion of proteins loaded in proline and glutamine It happens in individuals with a mean prevalence of around 1% of the population. In a retrospective investigation on 530 patients suspected of having celiac disease, we found a moderate agreement between endoscopy and pathology findings (kappa = 0.42). Pathological affirmation of these typical small bowel alterations is at present accepted as the gold standard to determine the diagnosis of celiac disease in individuals with positive antibody titer. Around 4 to 6 duodenal biopsies, counting a bulb biopsy, are necessary to present the diagnosis of celiac disease [7,9,10,11,12,13]
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