Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Çocukluk Çağı Çölyak Hastalığında Tanısal Faktörlerin Değerlendirilmesi: Tanımlayıcı Retrospektif Araştırma
Evaluation of Diagnostic Factors in Childhood Celiac Disease: Descriptive Retrospective Research
Bilge ŞAHİN AKKELLEa, Burcu VOLKANa, Engin TUTARa, Deniz ERTEMa
aMarmara Üniversitesi Tıp Fakültesi, Çocuk Gastroenteroloji, Hepatoloji ve Beslenme BD, İstanbul, Türkiye
Turkiye Klinikleri J Pediatr. 2022;31(3):179-84
doi: 10.5336/pediatr.2022-90266
Article Language: TR
Full Text
ÖZET
 Amaç: Son yıllarda artan farkındalık ve tanı olanaklarıyla çölyak hastalığı (ÇH) tanısı alan hasta sayısının arttığı düşünülmektedir. Çalışmamızda yıllara göre ÇH tanı sıklığının ve tanıya katkıda bulunan faktörlerin değerlendirilmesi hedeflenmiştir. Gereç ve Yöntemler: Çalışmamızda, 2010-2015 ve 2016-2021 yılları arasında ÇH tanısı alan çocuk hastalar sırasıyla Grup 1 ve Grup 2 olarak tanımlandı. Hastalar demografik özellikleri, semptomları, komorbiditeleri, refere edildikleri merkezler açısından değerlendirildi ve veriler gruplar arasında karşılaştırıldı. Bulgular: Çalışmaya dâhil edilen 257 hastanın %37,4'ü (n=96) Grup 1'i oluşturmaktaydı. Tipik/atipik semptomların sıklığı gruplar arasında benzerdi (p>0.05). Tarama sonucu tanı alan asemptomatik hasta oranı Grup 1'de %14,6, Grup 2'de %31,1'di ve gruplar arasındaki fark anlamlıydı (p<0,05). Taramayla tanı alan hastaların çoğunluğu Tip 1 diabetes mellitus tanılı hastalardan (%57,6) oluşmaktaydı. Grup 1'deki hastaların %41,7'sinde, Grup 2'deki hastaların %35,2'sinde ilk başvuru çocuk gastroenteroloji polikliniğine yapılmıştı. Genel pediatri polikliniklerinden refere edilen hasta oranları her iki grupta benzerken, diğer yan dal polikliniklerinden refere edilen hasta oranında son 6 yıllık dönemde artış saptandı. Sonuç: Çalışmamızın sonuçlarına göre son yıllarda ÇH tanısı alan olgu sayısı artmıştır. ÇH ilişkili atipik semptomlar konusunda 1.basamak sağlık hizmetleri veren hekimlerde farkındalığın artması ve tarama programları, yeni vakaların teşhisi için en önemli kaynaklardır.

Anahtar Kelimeler: Çocukluk; çölyak hastalığı; tanı
ABSTRACT
 Objective: It is thought that the number of patients diagnosed with celiac disease (CD) has increased with growing awareness and diagnostic possibilities in recent years. In our study, it was aimed to evaluate the change in the incidence of CD over the years and the factors contributing to the diagnosis. Material and Methods: In our study, pediatric patients diagnosed with CD between 2010-2015 and 2016- 2021 were defined as Group 1 and Group 2, respectively. Patients were evaluated in terms of demographic characteristics, symptoms, comorbidities, centers from which they are referred and the data were compared between the groups. Results: Of 257 patients, 96 (37.4%) were included into Group 1. The frequency of typical/atypical symptoms were comparable between the groups (p>0.05). The rate of asymptomatic patients, diagnosed by screening was higher in Group 2 (31.1% vs. 14.6%; p<0.05). The majority (57.6%) of the patients, diagnosed by screening, were patients with Type 1 diabetes mellitus. Pediatric gastroenterology was the first admission outpatient clinic for 41.7% of patients in Group 1 and 35.2% of patients in Group 2. While the referral rates from general pediatric outpatient clinics were similar in both groups, there has been an increase in the rate of referrals from other pediatric subspecialty clinics during the last 6 years. Conclusion: According to the results of our study, the number of cases diagnosed with CD has increased in recent years. Increasing awareness among primary care physicians about CD-related atypical symptoms and screening programmes are the major sources for diagnosis of new cases.

Keywords: Childhood; celiac disease; diagnosis
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