Serological markers of inflammatory bowel disease in children from the western region of Saudi Arabia

Serological markers including peri-nuclear anti-neutrophil cytoplasmic antibodies [pANCA] and anti-Saccharomyces cerevisiae antibodies [ASCA] have been reported in relation to inflammatory bowel disease [IBD]. The aim of this study was to ascertain the prevalence and diagnostic accuracy of pANCA and ASCA antibodies in Saudi children with IBD. A retrospective case-control study of children with IBD seen at King Abdulaziz University Hospital, Jeddah, between September 2002 and February 2012. The study included 131 patients with IBD [86 Crohn's disease [CD] and 45 ulcerative colitis [UC]] and 67 non-IBD control subjects. Females comprised 51% of CD, 60% of UC and 52% of non-IBD controls. The mean age was 10.7 +/- 5.2 years for CD, 8.9 +/- 5 years for UC, and 11.2 +/- 6.8 years for the non-IBD controls. Positive ASCA-IgA and ASCA-IgG were detected in 35.8% and 35% of CD patients and in 5.8% and 3.7% of the non-IBD controls, respectively. The pANCA was detected in 28.9% of UC patients and in none of the non-IBD controls. The pANCA recognised the myeloperoxidase [MPO] antibody in 36.4% of the patients with UC. No significant difference in the frequency of pANCA between extensive disease and disease limited to the rectosigmoid colon [p = 0.48], and no significant difference in the ASCAs antibodies in patients with or without involvement of the terminal ileum [p = 0.81]. The prevalence of ASCA and pANCA antibodies was low in Saudi children with IBD. Therefore, it may not be useful as a screening tool for IBD but it may be employed to aid the diagnosis in clinically suspected cases

Prevalence of celiac disease in children with type 1 diabetes mellitus screened by anti-tissue transglutaminase antibody from western Saudi Arabia

To determine the prevalence of celiac disease [CD] in children and adolescents with type 1 diabetes mellitus [T1DM] using anti-tissue transglutaminase [anti-tTG] antibodies. A retrospective hospital record-based study of all children and adolescents with T1DM who were screened for CD was conducted at the Pediatric Diabetes Clinic of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia [KSA] between October 2002 and June 2011. A total of 430 children with T1DM were screened by anti-tTG antibody. The median age at screening was 10.7 years [range; 1.1-18]. The study cohort included 232 [54%] Saudi patients, and females constituted 58.8% of the total number. Anti-tTG antibody screening was positive in 91 [21.2%] patients. Forty-eight [11.2%] out of 430 children screened had biopsy-proven CD. Forty-two patients with CD [87.5%] were asymptomatic. Patients with CD had less weight for age [p=0.007], and height for age [p=0.03] z-scores than non-CD patients. They showed more association with anemia [p<0.001], low albumin level [p<0.001], and autoimmune thyroid disease [p=0.002]. There was no difference in the mean glycosylated hemoglobin level [p=0.38], or insulin requirements [p=0.74] between the 2 groups. The prevalence of CD in patients with T1DM from the Western region of KSA is considered among the highest reported. Therefore, routine screening through proper serological testing is recommended.

Serum concentrations of interleukin-1 alpha, interleukin-6 and tumor necrosis factor-alpha in neonatal sepsis and meningitis

To investigate whether serum levels of interleukin-1alpha [IL-1alpha], IL-6, tumor necrosis factor alpha [TNF-alpha], C-reactive protein [CRP] are useful in the diagnosis of neonatal sepsis and meningitis and differentiate them. Blood samples were collected from 35 full term neonates with suspected infection who admitted to the Neonatology Unit, Pediatric Department, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia during January 2002 - June 2003. On the basis of laboratory and bacteriological results, newborns were classified into: sepsis [n=28], meningitis [n=7], and healthy controls [n=16]. Sepsis groups were further subdivided according to culture results into: group 1 = proven sepsis [n=6], group 2 = clinical sepsis [n=14], and group 3 = possible-infected [n=8]. Serum levels of IL-1alpha, IL-6, TNF-alpha were measured using Enzyme-Linked Immunosorbent Assay while CRP by nephelometer. In sepsis and meningitis patients, serum levels of CRP [p<0.01, p<0.05,] and IL-1alpha [p<0.001, p<0.05] were elevated than controls. C-reactive protein levels elevated in proven sepsis [p<0.001] and IL-1alpha elevated in all subgroups of sepsis [groups 1, 2, 3] compared with [p<0.05, p<0.001, p<0.01] controls. Interleukin-6, TNF-alpha showed no significant differences between studied groups. In sepsis and meningitis, IL-1alpha had a highest sensitivity [89%, 86%], and negative predictive values [89% and 93%]. Interleukin-1alpha and CRP increased in neonatal sepsis and meningitis, but cannot differentiate between them. Interleukin-1alpha had a highest sensitivity in prediction of neonatal infection and its assessment may improve accuracy of diagnosis