Association Between Severity of Small Intestine Mucosal Changes with Positive Endomysial Antibody in Children with Celiac Disease at Zahedan

Abstract

Background: Coeliac disease is triggered by ingestion of gluten-containing cereals in genetically susceptible subjects. The aim of the study was to analyze correlation between serum antiendomysial antibody and antiglidin antibody and the grade of pathology in small intestine mucosa in children with celiac disease.

Materials and Methods: This cross-sectional analysis was carried out in a group of 40 children (23 boys, 17 girls) with age range of 1.5- 14 years. The IgA-EMA, IgAAGA and total IgA were evaluated in all subjects. All patients underwent endoscopic small intestine biopsy. Histopathologic assessment was evaluated with Marsh criteria.

Results: EMA and AGA were positive in 77.5 and 87.5%, respectively. The most common clinical presentations were underweight, chronic diarrhea and anemia. Histopathological assessment of small intestine mucosal biopsy revealed Marsh I, II, IIIa, IIIb and IIIc in 15%, 27.5%, 40%, 12.5% and 5%, respectively. From two serological tests, EMA showed a statistically significant correlation with the grade of pathology. Sensitivity of antiendomysial antibody was 100% in Marsh III.

Conclusion: This study demonstrated significant correlation between the presence of serum antiendomysial antibodies and the grade of pathology in small intestine mucosa.