Incidence Of Celiac Disease Research Articles

Incidence of Celiac Disease in Children with Down’s Syndrome

Aim: Incidence of celiac disease among children with down’s syndrome Setting: Pediatrics department, Khyber Teaching Hospital, Peshawar Study design: Cross sectional study Study duration: 20/7/2019 to 20/1/2020 Methodology: A total of 241 subjects were selected. Five ml of venous blood was obtained from all patients to detect the Anti-tTG Ab. Among those patients who are positive for the antibody, endoscopy and biopsy specimen from duodenum were sent to hospital laboratory to confirm the presence of villus atrophy. Results: Mean age was 8 ± 4.57. 44% children were male and 56% children were female. More over 4% children had celiac disease and 96% children didn’t have celiac disease. Conclusion: The frequency of celiac disease was 4% among children presenting with Down syndrome. Keywords: Celiac disease, Down’s syndrome.

Underutilization of diagnostic assays for celiac disease in Korea.

BackgroundTest utilization for the diagnosis of celiac disease may affect the prevalence and incidence of the disease in Korea. We aimed to investigate the test utilization of serological biomarkers for celiac disease in Korea.MethodsWe retrospectively investigated the test utilization of tissue transglutaminase IgA, gliadin IgA and IgG, and endomysial IgA antibody (Ab) assays between January 2011 and June 2020.ResultsDuring a nine‐year‐and‐six‐month study period, overall 307,322,606 clinical tests were requested from different clinical settings, such as local clinics, hospitals, university hospitals, and tertiary medical centers. Among them, only 58 tissue transglutaminase IgA, 22 gliadin IgA, 12 gliadin IgG, and 16 endomysial IgA Ab tests were performed on 79 Korean patients. Among them, one patient had positive transglutaminase IgA Ab result (1.3%).ConclusionLow prevalence and incidence of celiac disease in Korea may be due to an underutilization of diagnostic assays.

S1334 Do Geriatric Patients Admitted With a Primary Diagnosis of Celiacs Disease Have a Higher Rate of Complications and Mortality Compared to Their Younger Counterparts?

Introduction: As the incidence of Celiac disease in the geriatric population increases, it is important to understand the disease course and specific complications they may be predisposed. The nuanced symptomatic presentation in the elderly can lead to severe complications as a result of delayed diagnosis. The aim of this study was to determine the rate of common complications and mortality of elderly patients as compared to younger patients admitted to the hospital with a primary diagnosis of Celiac disease. Methods: The National Inpatient Sample 2001-2013 database was queried for patients with a diagnosis of Celiac Disease using International Classification of Diseases, Ninth Revision (ICD-9) codes. Myocardial Infarctions, Pneumonia, Urinary Tract Infections, and Acute Renal Failure were identified with their respective ICD-9 codes. A chi-square analysis was performed to determine variables to be included in a multivariable analysis. A binary logistic regression analysis was used to examine demographic and other important variables, with a significance level of P < 0.001. Results: A total of 87,823 patients were identified with Celiac, of which 25,818 (29.4%) were age 65 or older. After incorporating demographic variables and social variables, such as biological sex, the geriatric population had a significantly higher likelihood of having a myocardial infarction (OR = 2.82), pneumonia (OR = 1.72), urinary tract infection (OR = 1.61), malnutrition (OR = 1.19), and acute renal failure (OR = 2.18). Geriatric patients with Celiac Disease had a significantly higher likelihood of dying during the hospital stay (OR = 10.24). Conclusion: There are many age-related differences in the presentation and clinical course of Celiac disease between the younger adult and geriatric population. The elderly population was found to be more likely to experience life-threatening complications as a result of Celiac disease. A greater understanding of factors contributing to the more complicated clinical courses of Celiac disease in the elderly is needed to improve quality of life and morbidity and mortality in this population. The markedly high likelihood of mortality in this population should be further investigated to prevent treatable causes of death.Figure 1.: Predictors of Complications in Geriatric Patients Admitted Primarily for Celiac Disease.

Celiac Disease.

Celiac Disease.

S1379 Celiac Disease on the Rise in the U.S. Military Population: Epidemiology and Impact on Operational Readiness

Introduction: Celiac disease (CD) is an increasingly common disease that affects approximately 1% of the global population and 1-2% of Americans. Recent population based data suggests an increase in the prevalence over the last several decades. Given this is a diagnosis that can preclude induction to the military and deployment to austere environments, we conducted a study to better define the epidemiology of celiac disease in the US military population Methods: Data were collected from the Defense Medical Surveillance System (DMSS) with a surveillance period of January 1, 2000, through December 31, 2017. The population included active component military service members of the US Army, Navy, Air Force, and Marine Corps who served during the period. An individual was counted as a case if they had at least 1 outpatient encounter with a qualifying International Classification of Diseases (ICD), Ninth and Tenth Revision code in any diagnostic position. Diagnoses from all military treatment facility clinics and gastroenterology (GI) specialty clinics only were included in this analysis to increase the specificity a celiac disease diagnosis. Results: A total of 3138 cases (888 within GI clinics) of CD were identified over the surveillance period. The annual incidence rates increased from 3.0 (1.5 within GI clinics) per 100,000 person-years in 2000 to 21.4 (6.5 within GI clinics) per 100,000 person-years in 2017. The prevalence rate increasing from 7.0 per 100,000 service members (3.3 within GI clinics) in 2000 to 87.9 per 100,000 service members (24.7 within GI clinics) in 2017. Prevalence was highest in women (181.8 vs 70.0 per 100,000 service members), age 46 and above (315.5 vs average of 121.1 per 100,000 service members) and white-non Hispanic (112.4 vs average of 57.1 per 100,000 service members). Conclusion: In a retrospective review of the DMSS over 18 years, the incidence and prevalence of CD within the US military is increasing; this may impact operational readiness and health and wellness of our military members. The incidence and prevalence varies with gender, age, and ethnicity. There is a need for further studies examining the military specific aspects of care for members with CD.

Screening for Celiac Disease in Newly Diagnosed Children with Type I Diabetes

Abstract Background Type I diabetes (T1D) is an autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic β cells.. Celiac disease is 5-7 percent more common in people with T1D than in the general population. Objectives The aim of this study was to detect the incidence of coeliac disease among newly diagnosed T1D children by assessment of Anti-tissue Transglutaminase Antibody (anti-tTG), IgA. Methods Fifty children with newly diagnosed T1D and another 15 age and sex –matched healthy individuals were subjected to screening for celiac disease by measuring total body IgA and antiTtg(IgA). Results the incidence of positive anti tTG(IgA) Ab among our T1D patients was found to be 12%. Upon comparing children with positive anti tTG(IgA) Ab with those with negative anti tTG(IgA) Ab we found that children with +ve anti tTG(IgA) Ab were significantly shorter than those with -ve anti tTG(IgA) Ab(p &amp;lt; 0.05). Also HbA1c among our diabetic children with +ve anti tTG(IgA) Ab was significantly higher than those with -ve anti tTG(IgA) (p &amp;lt; 0.05). Gastrointestinal manifestations were significantly higher among T1D patients with anti tTG (IgA)+ve than those with anti tTG(IgA)- ve.(p &amp;lt; 0.001). Conclusion Anti tTG(IgA) Ab levels are elevated in children and adolescents with type 1 diabetes compared with healthy controls with incidence rate of about 12%. Anti tTG(IgA) Ab test can be used as screening test for celiac disease among type1 DM.

Serological Screening of Celiac Disease in Patients with Juvenile Idiopathic Arthritis.

There is a possible association between celiac disease (CD) and juvenile idiopathic arthritis (JIA). Our aim was to evaluate the serological incidence of CD in patients with JIA. Children under 16 years of age with JIA who did not respond adequately to routine treatment, who referred to the pediatric centers of Tehran University of Medical Sciences (2017-2019), were enrolled in this study. Manifestations of CD were also evaluated. CD-related serological screening tests were measured. Seventy-eight patients were enrolled in the study. Their mean age was 7.9±3.9 (1.6-16) years. Three patients with oligoarticular JIA had Anti-TTG-Ab levels above normal (prevalence=3.8%). None of them had symptoms of CD. There were no significant statistical differences in terms of growth disorders, sex distribution, and different subtypes of JIA (P value ˃ 0.05) between the groups (sero-positive vs. sero-negative). In one case, CD was confirmed by pathology and the gluten-free diet was recommended. The absence of CD symptoms in patients with JIA does not rule out concomitant CD.

Two waves of coeliac disease incidence in Sweden: a nationwide population-based cohort study from 1990 to 2015

ObjectivesTo assess the incidence of biopsy-verified coeliac disease (CD) in Sweden and examine the incidence of duodenal/jejunal biopsies with normal mucosa over time as a proxy for CD awareness and...

Nonalcoholic fatty liver disease is associated with a higher incidence of coeliac disease.

Recently the incidence of nonalcoholic fatty liver disease (NAFLD) has risen to become the most frequent liver disease worldwide. NAFLD is not a disease limited to the liver, but rather represents a systemic inflammatory disease involving multiple organ systems. Previous studies have suggested an association between NAFLD and coeliac disease, another disease related to inflammation. As the available clinical data is scarce and at least partially contradictory, we aimed at investigating a potential association between NAFLD and celiac disease in outpatients in Germany. Using the Disease Analyzer database featuring data on diagnoses, prescriptions and demographic variables for 7.49 million cases of patients followed in general practices in Germany, we matched a total of 57 336 patients with NAFLD/diagnosed between 2000 and 2015 to a cohort of equal size without NAFLD by age, sex and index year. Incidence of celiac disease was compared between groups within 10 years from the index date. During the 10-years observation period, we observed a higher incidence of coeliac disease in NAFLD patients compared to patients without NAFLD (11.2 vs. 7.5 cases per 100 000 patients' years). Interestingly, this association was most prominent in men (hazard ratio, 2.02; 95% CI, 1.01-4.04) and patients between 18 and 50 years (hazard ratio, 2.79; 95% CI, 1.12-6.94). Our data suggest that NAFLD promotes the development of coeliac disease particularly in young men. This finding argues that coeliac disease should be recognized as another nonliver-related complication of NAFLD and suggests screening of selected NAFLD patients for the presence of coeliac disease.

Systematic review and meta-analysis: the incidence and prevalence of paediatric coeliac disease across Europe.

Coeliac disease is one of the most prevalent immune-mediated gastrointestinal disorders in children. To review the incidence and prevalence of paediatric coeliac disease, and their trends, regionally across Europe, overall and according to age at diagnosis. Systematic review and meta-analysis from January 1, 1950 to December 31, 2019, based on PubMed, CINAHL and the Cochrane Library, searches of grey literature and websites and hand searching of reference lists. A total of 127 eligible studies were included. The prevalence of previously undiagnosed coeliac disease from screening surveys (histology based) ranged from 0.10% to 3.03% (median=0.70%), with a significantly increasing annual trend (P=0.029). Prevalence since 2000 was significantly higher in northern Europe (1.60%) than in eastern (0.98%), southern (0.69%) and western (0.60%) Europe. Large increases in the incidence of diagnosed coeliac disease across Europe have reached 50 per 100000 person-years in Scandinavia, Finland and Spain. The median age at diagnosis increased from 1.9years before 1990 to 7.6 since 2000. Larger increases in incidence were found in older age groups than in infants and ages <5years. Paediatric coeliac disease incidence and prevalence have risen across Europe and appear highest in Scandinavia, Finland and Spain. The most recent evidence shows large increases in incidence in most regions, but stabilisation in some (notably Sweden and Finland). Sharp increases in the age at diagnosis may reflect increases in milder and asymptomatic cases diagnosed since reliable serology testing became widely used, through endomysial antibodies after 1990 and tissue transglutaminase antibodies around 2000.

The Relation between Type One Diabetes Mellitus and Occurrence of Celiac Disease in Patients with in Babylon Teaching Hospital for Maternity and Children

Although the association between type 1 diabetes mellitus and celiac disease is well known, the presentingfeatures and clinical characteristics of the two diseases, when they coexist, are less well documented sothe study aimed to Estimate the incidence of celiac disease among patients attended to diabetic clinic inthe Babylon maternity and pediatric teaching hospital. Include retrospective study involves patients withT1DM attending the pediatric diabetic clinic in the Babylon maternity and pediatric teaching hospital, werescreened for celiac disease by serological testing for celiac antibodies (tissue transglutaminase). Controlgroup without diabetes mellitus were also been evaluated. The control group are those who were admitted tothe hospital for other diseases like gastroenteritis or chest infection, have no past medical history or chronicillnesses, and have no diabetes mellitus neither symptoms nor abnormal blood investigation results. Of the50 patients with T1DM and 50 without diabetes mellitus, 3 patients (6%) of the study group tested wereantibody positive. Celiac disease presented atypically in the majority of cases with an unpredictable intervalbetween diagnosis of diabetes and celiac disease presentation. In this study, we found that patients withclassical symptoms of celiac disease, (diarrhea, anorexia, abdominal distension, foul smelling stool, shortstature, unexplained hypochromic anemia), may have negative screening for celiac disease, while those withpositive screening test, were asymtomatic.

Patients With Inflammatory Bowel Disease on Treatment Have Lower Rates of Celiac Disease.

The association between celiac disease and inflammatory bowel disease (IBD) has been studied; however, the impact of IBD therapy on celiac disease is not known. Using a large database, we sought to describe the association of celiac disease and IBD and the impact of IBD treatment. We queried a large multicenter database (Explorys Inc.), an electronic health record data aggregate from 26 American health care systems. We identified a cohort of patients with celiac disease and IBD between 1999 and 2020 and conducted a statistical analysis using a multivariate model. Of the 72,965,940 individuals in the database, 133,400 had celiac disease (0.18%), 191,570 (0.26%) had ulcerative colitis (UC), and 230,670 (0.32%) had Crohn disease (CD). Patients with IBD were more likely to have a diagnosis of celiac disease (odds ratio [OR], 13.680), with a greater association with CD. Treated patients with UC and with CD, respectively, had a lower risk association with celiac disease compared to those not undergoing IBD treatment, specifically corticosteroids (OR, 0.407 and 0.585), 5-aminosalicylates (OR, 0.124 and 0.127), immunomodulators (OR, 0.385 and 0.425), and anti-tumor necrosis factor drugs (OR, 0.215 and 0.242). There was no lower risk association in the vedolizumab group, but there was a higher risk association among the ustekinumab group. In this large dataset, we showed a bidirectional association between celiac disease and IBD that was stronger with CD. Patients with IBD treated using corticosteroids, 5-aminosalicylates, immunomodulators, or anti-tumor necrosis factor drugs had a lower association with celiac disease. Additional studies are required to determine the underlying mechanisms for IBD therapy-related modification of celiac disease incidence.

The Underlying Effects of Celiac Disease and Subsequent Implications on Deployment in the United States Army.

The purpose of this review is to provide an overview of the etiology, pathology, and treatments for celiac disease (CD), as well as to provide context as to how CD impacts the U.S. military. To conduct this review, the authors surveyed recent epidemiology and immunology literature in order to provide a detailed summary of the current understanding of CD, its diagnosis, and the real-world impacts within the Department of Defense (DoD). We described the gluten proteins and both the immune response in CD. We further describe the underlying genetic risk factors and diagnosis and pathogenesis of the disease and conclude the review with a discussion of how current DoD regulations impact U.S. military readiness. Celiac disease (CD) is an autoimmune disorder that results in damage to the small intestine. Ingestion of gluten in a CD patient is usually followed by villous atrophy in the small intestine, often along with other gastrointestinal symptoms. Around 1% of patients diagnosed with CD can experience complications if gluten-free diet is not followed, including intestinal lymphoma and hyposplenism. Therefore, a patient showing possible symptoms should discuss the diagnostic process with their healthcare providers to ensure adequate understanding of serological and genetic tests along with the histological examination of intestinal biopsy. Patients should seek consults with registered dietitians to structure their diets appropriately. Considering the prevalence and incidence of CD and gluten intolerances are increasing, the military should consider providing gluten-free Meals Ready-to-Eat as an option for all service members. Given the retention of service members with CD, subsequent admission of personnel with mild CD that does not affect the duties will allow the DoD access to a growing population of fully capable service members with critical technical skills who are eager to serve the USA.

Early introduction of high-dose gluten reduces the incidence of coeliac disease.

Early introduction of high-dose gluten reduces the incidence of coeliac disease.

Does cystic fibrosis make susceptible to celiac disease?

Patients with cystic fibrosis (CF) have a higher incidence of celiac disease (CD) than the healthy population; however, the actual incidence of coexisting CF and CD is unclear. In this report, we aimed to evaluate the frequency of CD and CF coexistence and to assess the clinical findings of affected patients during follow-up. We conducted a retrospective review of patients with CF to reveal the frequency of CD and also investigated the clinical characteristics and clinical response to gluten-free diet in patients with CD. The incidence of CD in 515 patients with CF was 1.4%. The median age at the time of CF diagnosis was 2 months (1-6 months). CD was diagnosed in six patients with poor weight gain, fatty stools, and low z score for BMI and one patient with poor weight gain despite a high protein and calorie diet and pancreatic enzyme replacement. The median age of CD diagnosis was 8 years (2-12 years). Except for one patient who was recently diagnosed, the other six patients gained weight and their accompanying symptoms resolved after starting a gluten-free diet.Conclusion: CD should be investigated in patients with CF in the presence of inadequate weight and/or height gain or poor control of malabsorption symptoms despite appropriate and adequate nutritional and enzyme replacement treatment. What is Known: • CFTR dysfunction may be a risk factor for CD, due to increased intestinal permeability and intestinal inflammation, pancreatic exocrine insufficiency that results in higher antigen load and increased antibodies against to nutritional antigens such as anti-gliadin IgA antibodies. • Although coexistence of CF and CD are rare in the same patient; there is still no consensus on when children with CF should be screened for CD. What is New: • Physicians should consider the investigation of CD in patients with CF, in the presence of inadequate weight and/or height gain or poor control of malabsorption symptoms despite appropriate and adequate nutritional and enzyme replacement treatment. • CFTR dysfunction has been emphasized to develop susceptibility to CD, and patients with CF who have persistent gastrointestinal symptoms despite appropriate and adequate nutritional and enzyme replacement treatment should be screened for CD.

The Epidemiological and Clinical Characteristics of Celiac Disease among Patientswith Irritable Bowel Syndrome in Zanjan Province, Iran

Background: There are some overlaps between celiac disease and irritable bowel syndrome symptoms (IBS). It can lead to misdiagnosis or delayed diagnosis of celiac disease. In some guidelines, it is recommended to screen for celiac in IBS cases. For assessment of the necessity for such diagnostic approaches in patients, this study was done to evaluate the epidemiological and clinical characteristics of celiac disease among IBS cases in Zanjan, Iran. Methods: In this descriptive cross-sectional study, 121 cases with IBS attending to gastroenterology clinics since 2015 to 2018 were enrolled. The laboratory tests and upper digestive endoscopy were performed for all patients. Endoscopic biopsy specimens were taken from the duodenum, and the samples were examined to confirm diagnosis of celiac disease. Data analysis was done by SPSS software. Results: Of 121 studied patients, 51.2% were male. The mean age of the patients was 36.65 ± 10.09 years old. The most common IBS subtype was mixed (80.2%). According to the serology results and Marsh grading, 4.1% and 1.6% had celiac disease and potential celiac disease, respectively. There were statistically significant differences among celiac disease in gastroesophageal reflux disease and abdominal discomfort/cramping. Conclusion: The incidence of celiac disease was evaluated 4.1 cases per each 100 patients with IBS, which was higher than recent similar studies, and screening for celiac disease in these patients is advisable. However, further studies with larger sample size are required to attain more definite results.

Influence of barley, corn and rice flour on physical, chemical and sensory characteristics of gluten-free bread

Abstract People suffering from the celiac disease have to apply a strict gluten-free diet because this is the only effective management. Nowadays, the increasing incidence of celiac disease promotes worldwide interests for various desirable gluten free products. As a consequence, food processing researchers have been seeking to develop high-quality gluten-free bread. Cereals having gluten such as wheat must be removed from the diet for the clinical and histological improvement. So, the purpose of this study was to determine the physical, chemical and sensory properties of gluten-free bread produced with barley (T1), corn (T2) and rice (T3) flours instead of wheat flour, using the 1.5 % xanthan gum. The chemical and sensory attributes of bread were evaluated by AOAC method and hedonic test, respectively. Obtained results showed that sample T3 had the highest contents of crude protein (7.94%), ash (2.51%) and carbohydrate (78.31%) as compared to other samples, while fat was lower (2.01%). Regarding moisture, breads prepared with the three different flours were not statistically different at the significance level of p&lt;0.05. However, they differed significantly regarding the specific volume and bake loss. Data also revealed that gluten-free bread, treatment T3 presented the best parameters, being preferred by the sensory evaluation panel, followed by treatment T1 and T2. The overall assessment pointed that the resulting breads treatment T3 was best for all physico-chemical characteristics and, in general, resulted in good sensory behavior, indicating that it could be a promising alternative to wheat flour.

Screening for celiac disease among patients of the gastroenterological profile

To determine the frequency of celiac disease (CD) among gastroenterological patients and criteria for its active detection. 1.358 patients referred for gastroenterologist consultation from 2016 to 2019 was conducted, of which 140 had CD (339 males 24.9%; 1019 females 75.1%). The average age was 40.415.4 (1886 years). All patients were determined anti-TTG IgA, IgG, and analyzed the clinical symptoms and analysis. The results were subjected to statistical processing Statistica 13.3 (StatSoft Inc., USA). In patients without CD (1218 people), high level of anti-TTG IgA and IgG was observed in 59 (4.8%), an increase in anti-TTG IgA in 54 (4.4%), and anti-TTG IgG in 38 patients (3.1%). The CD diagnosis confirmed in 51 patients (4.2%). The main symptoms were diarrhea (88%), abdominal pain (60.7%), bloating (73.8%), nausea (40.3%), weight loss (44.3%). Anemia was determined in 31.6%, serum iron 33%, hypoproteinemia 12.6%, hypoalbuminemia 12%, hypokalemia 5.48%, hypocalcemia 21.9%. An increase in the level of AST 14.5%, ALT 14.6%. Comparative analysis showed that in the group with newly detected CD, anemia, malabsorption syndrome, increase AST, ALT were significantly more frequent than in patients with normal antibodies, which confirms the need to detect CD among patients with these laboratory abnormalities. The incidence of CD among patients with a gastroenterological symptoms was 4.2%. Analysis of clinical and laboratory data has shown that a comprehensive analysis of clinical symptoms and laboratory indicators at the stage of primary treatment will allow timely identification of CD patients and prescribe GFD.

Diagnosis of celiac disease is being missed in over 80% of children particularly in those from socioeconomically deprived backgrounds.

Population-based screening studies have documented prevalence of celiac disease (CD) at 1% at age 7 years, but 90% of children remain undiagnosed. This prospective cohort study aims to examine whether observed differences in diagnosis rates of CD exist between children from different socioeconomic groups and how this has changed over a 12-year period. All children aged ≤15 years with a postcode within South West of England (SWE) diagnosed with CD during a 12-year period (1999-2010) when all diagnoses were based on endoscopic histology were included in the study. The incidence rates in socioeconomic groups were determined using the Index of Multiple Deprivation Score and Office of National Statistics population data. Four hundred fifteen children were diagnosed with CD; 65 withinthe City of Bristol (CoB). Diagnosis rate rose 4.2 times in SWE and 3.1 times in CoB between the first and last 4 years of the study. The rate was 1.6 times higher in the least socioeconomically deprived compared to most deprived (2.2 times in CoB), and the gap widened over the 12 years. Missed cases estimates for CoB and SWE are at least 83% and 91%, respectively.Conclusion: These findings suggest that while incidence of diagnosed CD in children has increased over a 12-year period, 83-91% remained undiagnosed. Socioeconomically deprived children are more likely to be underdiagnosed, and the gap between the least and most deprived has widened. To fully address massive underdiagnosis, further strategies including pilot studies using finger prick serological mass screening for CD in children entering primary schools are needed. What is Known: • Epidemiological studies record a 1% prevalence of celiac disease (CD), but up to 90% of children may remain undiagnosed. • Previous studies have documented an increased incidence of CD in higher socioeconomic groups, but proposed reasons remain conflicting. What is New: • Incidence of diagnosed CDhas gone up across all social classes but more so in higher socioeconomic groups and there is an increasing health/wealth gap. • This study estimates that 83-91% of children with CD are still being missed despite improved and easily available serological testing and suggest that population screening should be reconsidered.

Acne as a common extraintestinal manifestation of celiac disease. Treatment approaches

Introduction. At present, global prevalence of celiac disease attracts increasingly greater attention of researchers. The study of its extraintestinal manifestations is a crucial task for early and timely diagnosis of the disease, as well as the identification of new risk groups. To date, there are only isolated publications concerning the study of celiac disease incidence in patients with acne. This topic is of particular interest since systemic retinoids with a hepatotoxic effect and antibiotics significantly affecting the intestinal microflora are the first-line drugs in the treatment of moderate and severe acne. Undoubtedly, these side effects influence on the course of acne in celiac patients. So, to prevent the complications of the treatment, it is necessary to search, develop and introduce into practice safe combinations, including drugs having a protective effect both for the intestinal microflora and for the liver. It is known that psyllium (Plantago ovata seed shells/Ispaghula husks) have similar effects.Objective. To study the effect of psyllium on the tolerability and effectiveness of systemic therapy with isotretinoin and doxycycline in patients with moderate acne with celiac disease. Material and methods. We examined 65 patients with celiac disease suffering from moderate acne, who were randomized into two groups – group 1 (taking an antibiotic – doxycycline) and group 2 (taking a systemic retinoid – isotretinoin), then each group was divided into two subgroups A and B, depending on the prebiotic intake (powder of oval plantain seeds shells Plantago ovata Forssk (psyllium). The patients were followed up for 8 and 24 weeks, respectively. All patients received adjuvant topical therapy. In each group, a medical check-up was done before treatment, 2 months after the onset and then after the treatment completion.Conclusion. Patients in both subgroups who received psyllium in addition to antibiotics and systemic retinoids treatment showed better results after treatment in terms of skin condition, overall health and quality of life.