L’évaluation De La Maladie Coeliaque Associée Aux Perturbations Thyroïdiennes Chez L’enfant Dans La Localité De MOSTAGANEM

Abstract

Celiac disease is an auto-immune disease induced by the ingestion of gluten contained in wheat, rye, barley and oat proteins, responsible for villous atrophy and malabsorption syndrome in individuals genetically predisposed. The gluten-free diet is the only treatment currently available to overcome complications. And this disease is associated with disorders of the thyroid gland, and this is the subject that we have addressed in our study. The aim of this study was to evaluate the results of screening for celiac disease and thyroiditis in children in the population of Mostaganem, and to evaluate the appearance of specific antibodies for these 2 diseases. In order to achieve this objective, a prospective study was conducted on 03 clinical cases with CD associated with thyroid disturbances. The data for these 3 patients come from the medical analysis laboratory Dr Ettalhi.M. The study population included 3 children, 2 girls and 1 boy, aged 2 to 14 years. Screening for autoimmune thyroiditis was performed using anti-TPO antibodies, and supplemented by TSH and FT3 and FT4 assays; that of celiac disease by antibodies (antigliadin; tissue antitransglutamina; antiendomysium; serum immunoglobulin A), the diagnosis being confirmed by duodenojejunal biopsy. Antithyroid antibodies appeared much earlier and were present at the time of diagnosis of celiac disease; 2 of whom were treated for hypothyroidism and 1 for hyperthyroidism. The frequency of antithyroid antibodies increases with age and is very high in girls. The rate of screening must be adapted to the evolution of antibodies according to age, which is very different in thyroiditis and in celiac disease. Finally, we insist on the value of early diagnosis based on immunological methods, in addition to intestinal biopsy, and better information for patients and their families in order to avoid complications and allow growth normal. Generally, a reference value makes it possible to interpret the results of the biomarkers obtained in exposure situations or for specific populations. When the observed concentration of the biomarker is far above the reference value, this means that the result of the assay is within the values found for a population different from the population studied in terms of (environment, nutrition, factors, etc.). Also, the control serum used does not correspond to the nature and to the biological and physiopathological factors of the population studied.