COELIAC DISEASE DURING THE PERIOD 2007.-2017.IN CHILD HOSPITAL KANTRIDA

Celijakija ili glutenska enteropatija je autoimuni poremećaj. Javlja se u genetički predisponiranih pojedinaca koji razviju imunološku reakciju na gluten. Cilj ovog rada je opisati i statistički obraditi učestalost te značajke kliničke slike i dijagnostičkih postupaka kod otkrivanja celijakije u djece i adolescenata od 0. do 18. godine života na Klinici za pedijatriju KBC-a Rijeka. Istraživanje je provedeno retrogradnom analizom podataka iz povijesti bolesti oboljelih kojima je bolest dijagnosticirana u razdoblju od 2007. godine do 2017.godine. Celijakija je dijagnosticirana u 81 djeteta. Kroz razdoblje od jedanaest godina među dijagnosticiranima je bilo 59% dječaka i 41% djevojčica. Celijakija je bila dijagnosticirana češće u skupini djece od 0 do 5 godina nego u svim drugim skupinama zajedno. Atipičnom kliničkom slikom se prezentiralo 44% oboljelih a tipičnom kliničkom slikom njih 56%. Tri najčešća simptoma celijakije su nenapredovanje na težini, abdominalne kolike i kronični proljev. Atrofija resica se pronašla u 87,65% oboljelih, povišene transglutaminaze kod 83,95% oboljelih te gen za HLA DQ2/8 kod 27,16%. Negativne vrijednosti tkivne transglutaminaze je imalo samo pet oboljelih dok su ostali svi imali pozitivne vrijednosti. Najveći postotak oboljelih je po MARSH klasifikaciji svrstan u tip III, njih 48%. Dobiveni podatci nameću potrebu provođenja sličnih istraživanja i u drugim bolničkim centrima u RH koja se bave dijagnosticiranjem, liječenjem i praćenjem oboljelih od celijakije s ciljem unaprjeđenja njihove sveobuhvatne skrbi.Celiac disease or gluten enteropathy is an autoimmune disorder. It occurs in genetically predisposed individuals who develop an immune reaction to gluten. The aim of this paper is to describe and statistically analyze the frequency of clinical manifestations and diagnostic procedures in the detection of celiac disease in children and adolescents from 0 to 18 years old at the Pediatric Clinic of KBC Rijeka. The study was conducted by a retrograde analysis of data from the medical history of the patients diagnosed in the period from 2007. to 2017. Celiac disease was diagnosed in 81 children. During the period of eleven years, among the diagnosed there were 59% boys and 41% girls. Celiac disease was diagnosed more frequently in the group of children between 0-5 years old than in all the other groups together. 44% of patients presented with atypical and 56% with typical form of celiac disease. The three most common presenting features of celiac disease were weight loss, abdominal colics and chronic diarrhea. Villous atrophy was found in 87.65% of patients, elevated transglutaminase in 83.95% of patients and the HLA DQ2/8 gene in 27.16%. Only five patients had negative serum values of tissue transglutaminase , while the others all had positive values. Using MARSH classification, the highest percentage of patients(48%) was classified as type III. The obtained results implied the need for conducting more similar analyses in other hospitals in the Republic of Croatia where celiac disease is diagnosed, treated and monitored, with a goal to enhance comprehensive care