Introduction
Wheat is the most consumed cereal and widely used in the food industry around the world. Uzbekistan is one of the top countries where wheat is a major component of the diet. However, digestive disorders can occur when certain specific components of wheat are consumed. These disorders are known as gluten-related diseases (GRD) which have gradually become an epidemiologically significant phenomenon, attracting the attention of the scientific community.
Aims & Methods
To investigate whether there are significant differences in the clinical and laboratory findings in pediatric patients with GRD in the Republic of Uzbekistan.
100 pediatric patients with newly diagnosed GRD were examined: 50 with celiac disease (CD), 16 with wheat allergy (WA), 34 with non-celiac gluten sensitivity (NCGS). The diagnosis of CD was based on the clinical, serological (antibodies to tissue transglutaminase IgA, G), histopathological and HLA class 2 genetical data. The diagnosis of WA was based on the clinical findings, examination of specific IgE to wheat, molecular diagnosis of allergy and the effect of GFD. The diagnosis of NCGS was based on the Salerno Experts' Criteria (2015).
Results
The median age of children with CD was 66.5±7.7 months; with WA was 49.6±5.2 months and with NCGS was 59.3±14.1 months. Diarrhea was observed in 38 (76.0%) children with CD, in 19 (55.9%) children with WA, and in 2 (12.5%) patients with NCGS. Abdominal pain (55.9%), bloating (85.3%) and atopic dermatitis (23.5%) were frequently observed in WA. Vomiting and anemia were observed more frequently in CD (44.0% and 30.0%). Among all examined patients the lowest physical development indexes were observed in CD with median values of SD of height: -2.16; SD of weight: -2.69 and SD of BMI -1.29. In children with WA SD of height was -1.15, SD of weight: -2.04 and SD of BMI: -0.8, indicating a moderate deficit of BMI in this type of GRD. In NCGS, even smaller changes were found on the physical development which showed SD of height: -0.97, SD of weight: -0.6 and SD of BMI: -0.06. Increased enzymes (ALT, AST) were observed in children: 9 (18.0%) with CD, 2 (5.9%) with WA and 1 (6.3%) with NCGS. Bilirubin was elevated in 9 (18.0%) of patients with CD and 3 (8.8%) of patients with WA. Low total protein levels were showed in 60.0% of patients with CD, whereas in children with WA and NCGS were only 8.8% and 2.5% respectively. The lowest serum calcium levels were fixed in CD patients (median 1.7±0.03). In NCGS and WA this index was higher (median 1,9±0,06).
Conclusion
Although celiac disease is the leading cause of the lowest rates of physical development and deficits among patients GRD, many other gastrointestinal symptoms are as common in pediatric patients with NCGS and WA as they are in celiac disease.
References
Disclosure
