Browsing by Subject "protein glutamine gamma glutamyltransferase antibody"

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    Diagnostic yield of upper gastrointestinal endoscopy in the evaluation of iron deficiency anemia in older children and adolescents
    (2011) Gulen H.; Kasirga E.; Yildirim S.A.; Kader S.; Sahin G.; Ayhan S.
    Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 ± 2.0 years and 7.9 ± 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment. © 2011 Informa Healthcare USA, Inc.
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    Relationship between duodenal histopathology and strong positive tissue transglutaminase antibodies in children with celiac disease; [Çölyak hastası çocuklarda duodenal histopatoloji ve güçlü pozitif doku transglutaminaz antikorları arasındaki ilişki]
    (Galenos Yayincilik,, 2015) Doğan G.; Ayhan S.; Yılmaz B.; Appak Y.Ç.; Dündar P.E.; Ecemiş T.; Ünal F.; Kasırga E.
    Introduction: In celiac disease (CD) strong positive tissue transglutaminase antibody (TTGA) levels (≥100 U/A) have been shown to almost always indicate villous atrophy. The aim of this study is to determine the sufficiency of ≥100 U/A Ig A type TTGA levels for diagnosis of CD. Materials and Methods: Results from duodenum biopsy performed due to positive TTGA in 197 children were retrospectively examined. IgA TTGA levels had a positive value of >18 U/A. Increases of 5 times or more than this threshold value (≥100 U/A) are accepted as strong positivity. CD diagnosis was made according to ESPGHAN criteria. A modified Marsh stage ≥2 was accepted as significant for CD. Results: Of the cases, 129 were female (65.5%) and 68 were male (34.5%). Duodenum histopathology was compatible with Marsh 0 for 1 case (0.5%), Marsh 2 for 17 cases (8.6%), Marsh 3a for 41 (20.8%), Marsh 3b for 81 (41.4%) and Marsh 3c for 57 (28.9%). The TTGA levels of 64 of the 197 cases (32.5%) were ≥100 U/A. In cases with strong positivity for TTGA the duodenum histology was compatible with Marsh 3 (villous atrophy) for 63 and Marsh 0 (normal histology) for 1 case (type 1 diabetic and asymptomatic for CD). For Marsh 3c TTGA levels ≥100 U/A had a sensitivity of 85.96% (95% CI: 74.2-93.7%), specificity of 89.29% (95% CI: 82.9-93.8%), positive predictive value of 76.56% (95% CI: 64.3-86.2%) and negative predictive value of 93.9% (95% CI: 88.4- 97.3%). Conclusions: This study showed that positive IgA TTGA levels (≥100 U/A) were almost always accompanied by Marsh 3 duodenal histopathological changes. Diagnosis of CD without biopsy may miss certain accompanying diseases, however in some cases with advanced examinations CD may be diagnosed by pediatric gastroenterology specialists without endoscopy. © The Journal of Current Pediatrics, published by Galenos Publishing.
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    Should we worry about the eyes of celiac patients?
    (SAGE Publications Ltd, 2020) Doğan G.; Şen S.; Çavdar E.; Mayalı H.; Cengiz Özyurt B.; Kurt E.; Kasırga E.
    Purpose: In this article, we evaluate subfoveal choroidal thickness in celiac patients with respect to adherence to the gluten-free diet and nonadherence to the gluten-free diet, comparing with age and sex matched healthy controls using spectral-domain optical coherence tomography. Materials and Methods: A case-control study among 42 celiac patients and 42 healthy participants was conducted in the Department of Pediatric Gastroenterology. Celiac patients of our policlinics compliant with spectral-domain optical coherence tomography examination enrolled in the study. Celiac patients had been asked verbally about their adherence to gluten-free diet, were evaluated according to negative or positive EmA and anti-TG2 for defining adherence, and were divided into two groups (adherence to gluten-free diet and nonadherence to gluten-free diet). Results: Subfoveal choroidal thickness was thinner in EmA (+) or anti-TG2 (+) eyes than EmA(−) or anti-TG2 (−) eyes in celiac patients, but it was not statistically significant. The mean subfoveal choroidal thickness values in eyes with celiac disease, whose diagnosis time was longer than 60 months, were thinner than shorter group. Longer duration of gluten-free diet was associated with adherence difficulty and thinner choroidal thickness (r = −0.15, p = 0.34). Adherence to gluten-free diet was 88.2% for children below the age of 60 months and 57.1% for children older than 60 months. Conclusion: In conclusion, in addition to other extraintestinal manifestations of celiac disease, diagnosis time longer than 60 months in pediatric celiac patients, nonadherence to the gluten-free diet, and antibody positivity should be focused on during ophthalmologic examination and choroid measurement. © The Author(s) 2019.