Date of Award
Medical Doctor (MD)
Celiac disease and inflammatory bowel disease (IBD) are immune mediated chronic gastrointestinal disorders that present with similar symptoms such as abdominal pain, diarrhea and growth failure. In adults, some studies have shown increased prevalence of celiac disease in patients with IBD while other studies have not. There is no published data looking at the prevalence of celiac disease in children with IBD. We aim to investigate the prevalence of celiac disease and anti-tissue transglutaminase (tTG) antibodies in children with IBD.
We performed a retrospective chart review of children with IBD followed routinely in our clinic over the last 4 years. These children were matched with a non-IBD control group of children presenting with gastrointestinal symptoms to GI clinic. All children were routinely screened for celiac disease with tTG-IgA and total IgA. Clinical, laboratory, and histological data were collected in all children. Abnormal tTG was defined as >30u/ml.
The study population included 130 children with IBD and 258 in the control group. The mean age of children was 14.6 ± 3 years and 58% were males. The IBD group included 75 children with Crohn’s disease and 55 with ulcerative colitis. Abnormal tTG levels were found in 6 patients in the IBD group and 20 patients in the control group (4.6% vs. 7.8%, p = 0.24). To further evaluate the presence of celiac disease, tTG positive children were tested with endomysial autoantibodies (EMA) and duodenal histology, leading to celiac diagnosis in one patient with IBD and 12 patients in the control group. Celiac disease prevalence was lower among children with IBD compared with the control group (0.8% vs. 4.7%, p = 0.07). False positive rates were 3.9% and 3.3% for the IBD and the control groups, respectively.
Children with IBD do not have higher prevalence of celiac disease compared to other children who present with gastrointestinal symptoms to a GI clinic. Prevalence of celiac disease in children with IBD (0.8%) is similar to that of reported prevalence (1%) in general population. Rates of false positive tTG antibodies are similar in children with IBD and the control group. Routine screening for celiac disease in children with IBD is not warranted.
Murshed, Farhan, "Prevalence Of Celiac Disease And Anti-Tissue Transglutaminase (ttg) Antibodies In Children With Ibd" (2017). Yale Medicine Thesis Digital Library. 2157.