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OC51 Anti-parietal cell antibodies in children with celiac disease. gluten free diet effect
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  1. Valeria Novicova1,2,
  2. Natalia Shapovalova1,
  3. Maria Revnova1,
  4. Elena Kalinina3,
  5. Sergei Lapin2,
  6. Olga Gurina1,
  7. Elena Dementieva1,
  8. Ruslan Nasyrov1
  1. 1St. Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation
  2. 2St. Petersburg First Medical University, St. Petersburg, Russian Federation
  3. 3Mechnikov I.I. North-Western State Medical, St. Petersburg, Russian Federation

Abstract

Aim To evaluate the prevalence of anti-parietal cell antibodies (APCA) in children with celiac disease(CD) and gluten free diet (GFD) effect

Methods The first group consisted of 58 children with chronic gastritis (CG) and newly diagnosed CD who didn’t adhere to the GFD, the second group included 49 children with CG and CD, who were on GFD. The comparison group 3 consisted of 69 children with CG and excluded CD. To confirm or exclude CD, according to the recommendations of ESPHGAN, the serological examination (anti-tTG IgG, IgA and anti-DPG IgG by ELISA), morphological study, were carry out for all patients. And 80 patients underwent genetic testing to determine the HLA-DQ2/HLA-DQ8 genes using PCR.

All patients underwent a same examination: histological study of gastric biopsies, histological verification of H. pylori infection and biopsy urease test. Identification of APCA: anti-Intrinsic Factor (ELISA) was carried out in 140 patient and anti- H+/K+ ATPase (ELISA) in 58. APCA, using indirect immunofluorescence reaction, were determined in 45 children. Immunohistochemical determination of anti-tTG deposits in the stomach and duodenal mucous was performed on 10 patients.

Results The frequency of elevated levels of APCA was in group 1 – 10,00%, in group 2–0%, in group 3– 5,43%(P1,2=0,012; P1,3=0,492; P2,3=0,065). The prevalence of fundal gastric atrophy didn’t differ statistically significant in groups, p>0,05 Correlation analysis didn’t reveal morphometric duodenal mucosal parameters association with the gastric mucosa in group1 and 3, p>0,05. In group 2 a strong direct correlations between the depth of the fundal gastric pits and depth of the duodenal crypts (r=0,818) and between number of parietal cells and intraepithelial lymphocytes in duodenum (r=- 0,369); p<0,05 were found. Deposits of anti-tTG antibodies was detected in duodenal mucous and wasn’t found in gastric mucous. APCA didn’t correlate with anti-tTG antibodies, p>0,05.

Conclusion The prevalence of APCA in children with CD (1:10) was higher than in children with isolated gastritis (1:20), but statistically not significant. However, the prevalence of APCA is less among patients on a GFD statistically significant. The possible protective effect of a GFD on APCA requires additional study.

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