Impact of Serological and Histological Factors on Neurological Manifestations in Children and Adults with Celiac Disease
10.5223/pghn.2021.24.2.197
- Author:
Ramin NIKNAM
1
;
Seyed Reza SERAJ
;
Mohammad Reza FATTAHI
;
Mohammadali NEJATI
;
Seyed-Mohsen DEHGHANI
;
Laleh MAHMOUDI
Author Information
1. Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Publication Type:Original Article
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2021;24(2):197-206
- CountryRepublic of Korea
- Language:English
-
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.
