Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy

Golnaz Ghazizadeh Esslami; Bahar Allahverdi; Reza Shervin Badv; Morteza Heidari; Nahid Khosroshahi; Hosein Shabani-Mirzaee; Kambiz Eftekhari

doi:10.1155/2021/1639745

Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy

Neurol Res Int. 2021 Apr 22:2021:1639745. doi: 10.1155/2021/1639745. eCollection 2021.

Authors

Golnaz Ghazizadeh Esslami¹, Bahar Allahverdi², Reza Shervin Badv³, Morteza Heidari⁴, Nahid Khosroshahi⁵, Hosein Shabani-Mirzaee⁵, Kambiz Eftekhari⁶

Affiliations

¹ Department of Pediatrics, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.
² Pediatric Gastroenterology and Hepatology Research Center, Children's Medical Center, The Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Pediatric Neurology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Department of Pediatric Neurology, Children's Medical Center, Pediatrics Center of Excellence, Department of Pediatric Neurology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Pediatrics, Bahrami Children's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Department of Pediatric, Bahrami Children's Hospital, Tehran, Iran.

Abstract

Background: Celiac disease is the inflammatory entropy caused by hypersensitivity to gluten, which occurs in susceptible individuals. Some studies have suggested a link between celiac disease and epilepsy in children. Our aim was to screen for clinical and paraclinical features of celiac disease in children with intractable epilepsy.

Methods: This was a cross-sectional study. Children aged 2 to 18 years with refractory epilepsy that referred to the pediatric neurology clinic within one year (2018-2019) were enrolled. Demographic and clinical characteristics of patients, especially clinical manifestations of celiac disease, were recorded in a questionnaire. A venous blood sample was sent to determine the total IgA, anti-tTG (IgA), and anti-endomysial antibody (IgA). Endoscopy was performed in cases where the celiac serological test was positive.

Results: Seventy children with idiopathic drug-resistant epilepsy (44 boys) were evaluated. The height-for-age index was 49.2% and the weight-for-age index was 38.2% less than normal. Constipation (48.6%), anorexia (25.7%), and abdominal pain (21.4%) were the most common gastrointestinal symptoms. Celiac serological tests were negative in all children. Therefore, endoscopy and bowel biopsy were not performed in any case.

Conclusion: Celiac disease was not found in any patient with intractable epilepsy. Gastrointestinal symptoms and growth disorders in this group may be related to the underlying disease or medications and not to celiac disease.