Celiac Disease in Children

Clinicopathological, Endoscopic and Serological Patterns of Celiac Disease in Children at Sohag University Hospital

The aim is to study the clinical, serological, endoscopic and histopathological characteristics and treatment outcome of children diagnosed with celiac disease in Sohag University Hospital

Study Overview

• Status: Completed
• Conditions: Celiac Disease in Children
• Intervention / Treatment: Procedure: Upper GIT endoscopy

Detailed Description

Celiac disease (CD), or gluten-sensitive enteropathy, is an immune-mediated enteropathy triggered by the ingestion of gluten-containing cereals (wheat, barley, and rye) in genetically susceptible individuals. Undiagnosed CD may cause intestinal (e.g. chronic diarrhea, failure to thrive) and/or extra intestinal (e.g. anemia, osteoporosis, dermatitis herpetiformis) manifestations.

The etiology of CD is multifactorial, with both genetic and environmental factors involved in disease development. Susceptibility to CD is primarily associated with the human leukocyte antigen HLA-DQ2 allele. The heterodimer DQA1*0501 and DQB1*0201 is detected in up to 95% of persons with celiac disease, with the remaining 5% expressing HLA-DQ8 (DQA1*0301, DQB1*0302). The frequency of these alleles in the general populations in Western countries is 20% to 30%. Therefore, an individual not carrying DQ2 or DQ8 alleles is extremely unlikely to develop CD.

Celiac disease is associated with a host of autoimmune diseases such as type 1 diabetes mellitus, autoimmune thyroid disease, Addison disease, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, and immunoglobulin (Ig) A deficiency. There is also an increased prevalence of CD in patients with genetic disorders such as Down syndrome and Turner syndrome.

Serologic testing is recommended as the first step in pursuing a diagnosis of CD, however, small-bowel mucosal biopsy is currently considered the gold standard for diagnosing CD. All serologic tests and small-bowel biopsies need to be performed while the patient is on a gluten-containing diet.

The characteristics of small intestine biopsies from CD include partial or complete villous atrophy, crypt hyperplasia, and intraepithelial lymphocyte infiltration.

According to the modified Marsh classification, the intestinal damage is divided into four stages. Stage 0 intestinal damage is characterized by the lesion invasion in the mucous layer, the increased number of intraepithelial lymphocytes and the presence of lymphocytes in the lamina propria, whereas Stage 1 damage features microscopic enteritis with an increase of intraepithelial lymphocytes. A feature of Stage 2 intestinal damage is crypt hyperplasia along with villous atrophy while Stage 3 is characterized by a complete atrophy of the intestinal villi.

Treatment of CD includes lifelong gluten-free diet. The clinical and histological benefits of a gluten-free diet (GFD) in the management of CD are well recognized showing that the degree of histological recovery is dependent upon how strict the patient adheres to the diet.

• Study Type: Observational
• Enrollment (Actual): 66

Contacts and Locations

Study Locations

• Egypt
  • Sohag, Egypt, 82524
    • Sohag University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study will include children who will be admitted to the department of pediatrics at Sohag University Hospital during the study period and which will be fulfilling the following eligibility criteria in addition to all children previously diagnosed with celiac disease in the last 1 years.

Description

Inclusion Criteria:

• Children less than 18 years.
• Both sexes.
• Children suffering from manifestations of celiac disease.
• Children previously diagnosed with celiac disease.

Exclusion Criteria:

• cases more than 18 years.
• Children diagnosed with other causes of malabsorption

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
patterns of celiac disease in children; clinicopathological, endoscopic and serological patterns of celiac disease in children	Procedure: Upper GIT endoscopy; upper GIT endoscopy of suspected cases and multiple biopsies will be taken for histopathological examination; Other Names: Upper endoscopy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with Clinicopathological, endoscopic and serological patterns of Celiac disease	clinical patterns of celiac disease include intestinal and extraintestinal manifestations. serological patterns include total IgA level, tissue transglutaminase IgA & IgG levels and endomesial IgA & IgG levels. Endoscopic patterns include patchy or generalized atrophy and scalloping of duodenal mucosa. Pathological patterns include features of mucosal atrophy and modified Marsh classification.	1 Year

Collaborators and Investigators

• Sponsor: Sohag University

Study record dates

Study Major Dates

• Study Start (Actual): August 25, 2024
• Primary Completion (Actual): March 3, 2025
• Study Completion (Actual): March 30, 2025

Study Registration Dates

• First Submitted: December 30, 2024
• First Submitted That Met QC Criteria: January 17, 2025
• First Posted (Actual): January 20, 2025

Study Record Updates

• Last Update Posted (Actual): April 9, 2025
• Last Update Submitted That Met QC Criteria: April 6, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: clinicopathological, endoscopic and serological patterns of celiac disease in children
• Additional Relevant MeSH Terms: Metabolic Diseases; Intestinal Diseases; Digestive System Diseases; Gastrointestinal Diseases; Malabsorption Syndromes; Celiac Disease
• Other Study ID Numbers: Soh-Med--24-11-10MS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No