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Enfermedad celíaca en niños con síndrome de Down / Celiac disease in children with Down syndrome
Velasco-Benítez, Carlos Alberto; Moreno-Giraldo, Lina Johanna.
  • Velasco-Benítez, Carlos Alberto; Universidad del Valle. Departamento de Pediatría. Hospital Universitario del Valle. Cali. CO
  • Moreno-Giraldo, Lina Johanna; Universidad Santiago de Cali. Cali. CO
Rev. chil. pediatr ; 90(6): 589-597, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058189
RESUMEN

INTRODUCCIÓN:

La enfermedad celíaca (EC) en niños con síndrome de Down (SD) ha sido publicada por varios paí ses, sin que existan datos para Colombia.

OBJETIVO:

Determinar la frecuencia y factores relacionados de EC en niños con SD, comparado con un grupo de niños sin SD, analizando las manifestaciones clínicas, inmunológicas y genéticas. PACIENTES Y

MÉTODO:

Fueron estudiados 209 niños, 1-18 años de edad (8,4 ± 4,1 años; 55,5% sexo femenino) 97 con SD y 112 sin SD usando como marcador serológico los anticuerpos anti-transglutaminasa (tTG2); se estudiaron variables de edad, genero, raza, ori gen, peso, talla y síntomas digestivos. A los niños con tTG2 positivos, se les realizó biopsia duodenal y genotipo. Se estimó la proporción de niños con SD, sin SD y EC y su IC95%; medidas de tendencia central, análisis univariado y bivariado, siendo significativa una p < 0,05.

RESULTADOS:

Ocho niños con SD (8,2%) y 5 niños sin SD (4,5%) fueron tTG2 positivos (p = 0,200). Ninguno presentó deficiencia de IgA sérica. Un niño con SD presentó EC con Marsh II (1,0%); y 2 niños con SD (2,1%) y 2 sin SD (1,8%), presentaron EC potencial (p = 0,432). Tres niños fueron HLA-DQ2. Hubo mayor opor tunidad de presentar EC en el grupo de pre-escolares (OR = 6,14 IC95% = 0,41-87,35 p = 0,0462).

CONCLUSIONES:

La frecuencia de EC por biopsia intestinal en estos niños con SD es muy inferior a lo relatado en la literatura, estando asociada al pre-escolar, y siendo su principal alelo el DQ2, hallazgos similares a lo descrito a nivel mundial.
ABSTRACT

INTRODUCTION:

Celiac disease (CD) in children with Down syndrome (DS) has been published by several countries, without available data for Colombia.

OBJECTIVE:

To determine the frequency and related factors of CD in children with DS, compared with a group of children without DS, analyzing the clinical, im munological, and genetic manifestations. PATIENTS AND

METHOD:

A total of 209 children between 1-18 years of age (8.4 ± 4.1 years, 55.5% female) were studied, 97 with DS and 112 without DS, using anti-transglutaminase antibodies as serological marker (tTG2). Variables of age, gender, race, ori gin, weight, height, and digestive symptoms were studied. Children with positive tTG2 underwent duodenal biopsy and genotype. The proportion of children with DS, without DS, and CD was esti mated and their 95% CI; measures of central tendency, univariate and bivariate analysis, considering a p < 0.05 significant.

RESULTS:

Eight children with DS (8.2%) and five children without DS (4.5%) were tTG2 positive (p = 0.200). None presented serum IgA deficiency. One child with DS presented CD with Marsh II (1.0%), and two children with DS (2.1%) and two without DS (1.8%), presen ted potential CD (p = 0.432). Three children were HLA-DQ2. CD was more likely in the preschool group (OR = 6.14 95%CI = 0.41-87.35 p = 0.0462).

CONCLUSIONS:

The CD frequency due to intestinal biopsy in children with DS is much lower than that reported in the literature, being associated with preschool, and having DQ2 as its main allele. These findings are similar to those described worldwide.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Celiac Disease / Down Syndrome Type of study: Diagnostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: South America / Colombia Language: Spanish Journal: Rev. chil. pediatr Journal subject: Pediatrics Year: 2019 Type: Article Affiliation country: Colombia Institution/Affiliation country: Universidad Santiago de Cali/CO / Universidad del Valle/CO

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Full text: Available Index: LILACS (Americas) Main subject: Celiac Disease / Down Syndrome Type of study: Diagnostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: South America / Colombia Language: Spanish Journal: Rev. chil. pediatr Journal subject: Pediatrics Year: 2019 Type: Article Affiliation country: Colombia Institution/Affiliation country: Universidad Santiago de Cali/CO / Universidad del Valle/CO