Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Impact of Serological and Histological Factors on Neurological Manifestations in Children and Adults with Celiac Disease

  • Niknam, Ramin (Gastroenterohepatology Research Center, Shiraz University of Medical Sciences) ;
  • Seraj, Seyed Reza (Gastroenterohepatology Research Center, Shiraz University of Medical Sciences) ;
  • Fattahi, Mohammad Reza (Gastroenterohepatology Research Center, Shiraz University of Medical Sciences) ;
  • Nejati, Mohammadali (Gastroenterohepatology Research Center, Shiraz University of Medical Sciences) ;
  • Dehghani, Seyed-Mohsen (Gastroenterohepatology Research Center, Shiraz University of Medical Sciences) ;
  • Mahmoudi, Laleh (Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences)
  • Received : 2020.06.07
  • Accepted : 2020.11.06
  • Published : 2021.03.15
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Abstract

Purpose: Celiac disease (CD) is a common autoimmune disease with extra-intestinal manifestations, including neurological disorders. There are few reports to assess various factors in increasing the chances of developing neurological disorders in CD, so we designed this study. Methods: All patients with CD at any age who had been referred to the Celiac Clinic were evaluated for neurological problems. CD was defined as IgA anti-transglutaminase antibodies (anti-tTG) of 18 IU/mL or higher in serology and Marsh type I or more severe in histopathological evaluation. Logistic regression analysis was used to evaluate the impact of various independent variables on the neurological manifestations. Results: A total of 540 patients enrolled in this study. A 360 (66.7%) of patients were children. A 64.8% and 35.2% were female and male, respectively. Overall, 34.1% of patients had neurological manifestation, including headache, neuropathy, epilepsy, and ataxia. The odds of developing neurological manifestations in children were significantly lower than in adults (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.45-0.96; p=0.03) and in patients with gastrointestinal (GI) symptoms significantly higher than in the group without GI manifestations (OR, 1.77; 95% CI, 1.18-2.63; p=0.005). Other variables, including Marsh classification (OR, 0.44; 95% CI, 0.18-1.11; p=0.08) and anti-tTG levels (OR, 1.00; 95% CI, 0.999-1.001; p=0.59) did not significantly increase the chances of developing neurological disorders. Conclusion: Our study showed that increasing age and the presence of GI symptoms, but not serological and histological findings, could increase the chances of developing neurological diseases in CD patients.

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References

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