PREVALENCE AND COMPLICATION OF CELIAC DISEASE AMONG SAUDI CHILDREN: A CROSS-SECTIONAL STUDY

Introduction: Celiac disease (CD) is a chronic and autoimmune disorder caused by inflammatory T-cells response to the gluten-containing proteins. This disease may be expressed due to genetic predisposition, an autoimmune disorder, or environmental factors. Methodology: This is a cross-sectional study that included only the pediatric population and aimed to determine the prevalence and complications of CD among children. A predesigned self-administered questionnaire was constructed by the researcher; it covered the socio-demographic data, the patients’ clinical data, including their state, the possible complications of the disease, and the diabetic patients. Results: A total of 729 children were included, 63.1% were females, and the ones aging above ten years ranked with 31.7%. The prevalence of CD was 32.4%, and only 11.2% were diabetic. More than half of this population did not suffer any complications at all (54.7%), while malnutrition and bone weakening were the most common complications with (27.8%) and (15.5%), respectively. Conclusion: There is a relatively low prevalence of CD among children. The majority of our population did not suffer any complications. Furthermore, malnutrition and bone weakening constituted the most frequent complications among the patients. Corresponding author: Dr. Hoda Jehad Abousada, Postal address: jeddah, 22338, email: dr.huda1992@outlook.com, telephone number: 00966545551291) ORCID ID: https://orcid.org/0000-0002-4938-0601 QR code IAJPS 2020, 07 (11), 284-289 Hoda Jehad Abousada et al ISSN 2349-7750 w w w . i a j p s . c o m Page 285 Please cite this article in press Hoda Jehad Abousada et al, Prevalence And Complication Of Celiac Disease Among Saudi Children: A Cross-Sectional Study. , Indo Am. J. P. Sci, 2020; 07(11). INTRODUCTION: Celiac disease (CD) is a chronic disease resulted from inflammatory T-cells response to the glutencontaining proteins in wheat (gliadin), barley (hordein), and rye (secalin), and they are collectively called gluten [1]. It is characterized by enteropathy, which is represented by histological adjustments of the small bowel of the mucosa, the presence of prototypical autoantibodies [2]. The expression of this disease can be immune-mediated, genetically predisposed, or due to environmental inflammatory reaction damages the small intestine’s lining and prevents it causes malabsorption [3]. The intestinal damage often causes diarrhea, fatigue, weight loss, bloating, and anemia, and can lead to serious complications [4]. Though celiac disease is mostly lifelong, having a gluten-free diet makes it very treatable; the mucosa of the small intestine is remodeled to their normal status, and subsequent tests for celiac disease-specific autoantibodies become negative [5]. CD was first described by Aretaeus the Cappadocian who lived in the 2 century AD [6]. He observed the distinctive stool and the chronicity of the condition and noticed that children are of the affected groups. Later in 1888, another physician called Samuel Gee described the clinical picture of childhood CD [7]. Furthermore, A Dutch pediatrician, Willem-Karel Dicke, discovered the interrelation between ingestion of gluten and CD symptoms was (1905-1962) [8]. CD is considered as a familial disorder; the firstdegree relatives of patients with CD have an increased risk of 5-10% to develop the disorder [9]. Researchers usually use twin studies to evaluate the genetic and environmental components of the susceptibility of the disease. Monozygotic and dizygotic twin both share typical environmental elements but vary by taking part in 100% and 50% of genetic variability, respectively [10]. Literature review According to the other previous study like, Celiac disease is more prevalent among at-risk individuals in Saudi Arabia. The objectives were to perform a meta-analysis for CD among risk populations in the Kingdom of Saudi Arabia (KSA), as well as a comparison with our previously reported meta-analysis in the normal population [11]. Another cross-sectional study aimed to assess the knowledge of CD among healthcare professionals in Riyadh, Saudi Arabia. The results found that knowledge regarding CD is poor among a significant number of physicians, including consultants, which can potentially lead to delays in diagnosis. Educational programs need to be developed to improve awareness of CD in the health care profession [12]. These findings indicate that it is an important subject for reviews and re-statistics to assess the knowledge of physicians about CD and the prevalence of the disease among specific groups. Additionally, this may be an adequate reason to link between the lack of comprehensive scientific knowledge of CD and its direct proportional relation to the increasing number of cases (unknown and not registered scientifically), there are cases that have not yet been discovered. Saadah et al. [13] conducted a retrospective study to estimate the prevalence of CD among children and adolescents with type 1 diabetes mellitus (T1DM) screened by anti-tissue transglutaminase (anti-tTG) antibodies from Western Saudi Arabia. The study found that CD with highly prevalent among these patients with T1DM; therefore, routine screening through proper serological testing is recommended. Rationale Statistical prevalence of the coeliac disease is still not fully known, perhaps because CD is unknown to many, even some doctors do not have comprehensive knowledge about the disease. This study will provide accurate statistics to assess the prevalence and complications of CD among a group of pediatric patients. Aim of the study This study aimed to determine the prevalence and complications of CD among children. It also aimed to determine which gender is more affected by CD, the most common complications, and to find out how diabetes is associated with celiac disease. Participants & Methodology Study type and population This is a cross-sectional study that included only the pediatric population of inand outpatients attending Ministry of Health hospitals in Saudi Arabia.