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P224 Hepatic transaminases activity in children during clinical manifestation of coeliac disease
  1. Leonid Klimov1,
  2. Irina Zakharova3,
  3. Marina Stoyan1,2,
  4. Victoria Kuryaninova1,2,
  5. Vyacheslav Kashnikov2,
  6. Svetlana Dolbnya1,
  7. Elena Gerasimenko1
  1. 1Pediatrics faculty, Stavropol State Medical University
  2. 2Pediatrics, Children Clinical Hospital by named G.K. Philippsky, Stavropol, Russia
  3. 3Pediatrics, Russian Medical Academy of Postgraduate Study, Moscow

Abstract

Background and aims Frequency of hypertransaminasemia (GT) in children and adolescents during clinical manifestation of coeliac disease (CD) period and correlation of transaminases activity with serological and morphological data.

Methods 206 children with CD at 8 months to 17 years of age (mean age is 5.0±0.3 years). The patients were assigned to two groups: the first group consisted of 94 (45.6%) children with GT, the second group consisted of 112 (54.4%) children with normal AST and ALT parameters.

Results Frequency of GT in children with CD decreases with age. At the age under 1 year GT was diagnosed in 8 (80.0%), at 1–3 years – in 51 (58.6%), at 3–7 years – in 26 (41.9%), at 7–11 years – 6 (27.3%), at the age of adolescence – in 3 (12.0%) cases. At the age under 3 years GT was diagnosed in 59 (60.8%), and over 3 years – in 35 (32.1%) patients (p<0.001). The mean age for verification of the diagnosis in the study groups was 3.4±0.3 years and 6.3±0.4 years (p<0.001). The first symptoms of CD in the first group of children occurred at the age of 1.2±0.1 years, in the second group – at 2.6±0.3 years (p<0.001). In patients with typical enteral syndrome GT was diagnosed in 90 (49.7%), and with extraenteric symptoms – in 4 (16.0%) cases (p<0.01). Correlation analysis showed a direct correlation between anti-tissue transglutaminase (anti-tTG) IgA and ALT (r=0.30, p<0.005) and AST (r=0.21, p<0.05). A direct correlation between Marsh jejunum atrophy stage and levels of ALT (r=0.58, p<0.001) and AST (r=0.48, p<0.001) was revealed.

Conclusions GT is significantly more frequently diagnosed in children with CD at early age. Transaminases activity in patients with CD correlates with anti-tTG IgA and IgG, and with the intensity of jejunum atrophy.

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