Abdulrahman Al-Hussaini1, Riccardo Troncone2, Musa Khormi3, Muath AlTuraiki4, Wahid Alkhamis5, Mona Alrajhi5, Thana Halal5, Mosa Fagih6, Sahar Alharbi6, Muhammed Salman Bashir7, Aziz Alami Chentoufi8. 1. Division of Pediatric Gastroenterology, Children's Specialized Hospital, King Fahad Medical City, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia. 2. Department of Medical Translational Sciences & European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy. 3. Division of Pediatric Gastroenterology, Children's Hospital, King Saud Medical City. 4. Department of Pediatrics at King Salman Hospital. 5. Ministry of Health, School Health Administration. 6. Department of Pathology and Laboratory Medicine, King Fahad Medical City. 7. Department of Biostatistics, Research Services Administration, Research Center at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. 8. Immunology/HLA Department, National Reference Laboratory, Mohammed VI University of Health Sciences, Casablanca, Morocco.
Abstract
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: During the study period (January 2014-June 2016), we have conducted a cross-sectional, mass screening, immunoglobulin A-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%). CD was diagnosed in 119 cases (1.5%, 1:67 Saudi children) (mean age 11.5 ± 2.62 years; girls 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 3 clinical patterns in the screening-identified cases with CD: a silent form (37%), a mild symptomatic form characterized by gastrointestinal symptoms in presence of normal growth or overweight/obesity (48%), and gastrointestinal symptoms associated with impaired growth in 15%. CONCLUSIONS: 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.
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: During the study period (January 2014-June 2016), we have conducted a cross-sectional, mass screening, immunoglobulin A-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%). CD was diagnosed in 119 cases (1.5%, 1:67 Saudi children) (mean age 11.5 ± 2.62 years; girls 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 3 clinical patterns in the screening-identified cases with CD: a silent form (37%), a mild symptomatic form characterized by gastrointestinal symptoms in presence of normal growth or overweight/obesity (48%), and gastrointestinal symptoms associated with impaired growth in 15%. CONCLUSIONS: 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.
Authors: Govind K Makharia; Prashant Singh; Carlo Catassi; David S Sanders; Daniel Leffler; Raja Affendi Raja Ali; Julio C Bai Journal: Nat Rev Gastroenterol Hepatol Date: 2022-01-03 Impact factor: 46.802
Authors: Ashraf El-Metwally; Paivi Toivola; Khalid AlAhmary; Salwa Bahkali; Ali AlKhathaami; Munira K AlSaqabi; Shatha A Al Ammar; Munazza Jawed; Saleh M Alosaimi Journal: Biomed Res Int Date: 2020-06-03 Impact factor: 3.411
Authors: Abdulrahman A Al-Hussaini; Abdullah N Al Jurayyan; Salman M Bashir; Dayel Alshahrani Journal: Saudi J Gastroenterol Date: 2019 Sep-Oct Impact factor: 2.485