Mass Screening for Celiac Disease Among School-aged Children: Toward Exploring Celiac Iceberg in Saudi Arabia.

Objectives: We conducted this mass screening study to determine the prevalence of celiac disease (CD) and characterize the celiac iceberg among Saudi pediatric population in Riyadh, the capital city of Saudi Arabia. Methods: Over the study period (January 2014 to June 2016), we have conducted a cross-sectional, mass screening, IgA-tissue transglutaminase (TTG-IgA)-based study on 7930 Saudi students from primary and intermediate schools in Riyadh. Students with positive TTG-IgA (> 20 U/L) were called in the hospital to undergo a repeat of TTG-IgA; in those with borderline positive TTG-IgA (20-60 U/L) IgA-endomyseal antibody (EMA-IgA) test was performed. Children with TTG-IgA > 60 U/L and children with borderline positive TTG-IgA and positive EMA-IgA were advised to undergo upper endoscopy and intestinal biopsies. Results: We identified 221 students with positive TTG-IgA (2.8%). Celiac disease was diagnosed in 119 cases (1.5%, 1:67 Saudi children) [Mean age 11.5 +/- 2.62 years; females 81 (68%)]. Another 51 children had persistently borderline positive TTG-IgA but negative EMA (0.64%) and the remaining 51 had transiently positive TTG-IgA. We have identified three clinical patterns in the screening-identified celiac cases: 1) a silent form (37%), 2) a mild symptomatic form characterized by gastrointestinal symptoms in presence of normal growth or overweight/obesity (48%), and 3) gastrointestinal symptoms associated with impaired growth in 15%. Conclusion: Our study provided evidence of a high prevalence of CD among Saudi children (1.5%); a rate that is at least twice the average prevalence rate in Europe and North America. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2tLsoK5
via IFTTT