Prevalence of Celiac Disease in Iranian Children with Recurrent Abdominal Pain Referred to a Pediatric Referral Center

Objective

Clinical features of Iranian children with celiac disease (CD) are still unknown and there is scant information about atypical presentation of celiac disease from Iran. The aim of this study was to determine prevalence of CD in Iranian children presenting with functional abdominal pain (FAP).

Methods

In this cross-sectional study, 301 children affected by FAP were screened for CD by anti-tissue transglutaminase antibody (tTG IgA). IgA antibody was also measured to exclude IgA deficiency. The antibodies were measured by enzyme linked immunosorbent assay. Diagnosis of CD was confirmed by duodenal biopsy that was scored according to the Marsh classification in cases with abnormal titer of tTG antibody.

Findings

A total of 301 children (138 males, 163 females) with FAP were studied. Endoscopic duodenal biopsy was taken for patients with positive and borderline tTG test. Two out of 301 cases were IgA deficient and celiac disease was suspected for one of them based on histological findings. Four out of 299 patients with normal IgA had abnormal tTG titer; intermediate ranges (16–23 U/ml) were detected in 1 and positive ranges (≥24 U/ml) in 3 cases. CD was suggested in all patients with abnormal titer of tTG (1.33%) based on histological findings.

Conclusion

The prevalence of celiac disease in children with FAP is estimated 1.3% (nearly 2 times higher than in normal population) in Iran.     

Comparison of mild and microdose GnRH agonist flare protocols on IVF outcome in poor responders

Purpose  

To compare the IVF outcome of clomiphene citrate/gonadotropin/antagonist (mild protocol) and microdose GnRH agonist flare protocols for poor responders undergoing in vitro fertilization.     

The efficacy of a 1-week triple therapy for eradication of Helicobacter pylori infection in children

Background and study aimsPoor compliance to therapy and antibiotic resistance are the main causes for failure of anti-Helicobacter pylori (H. pylori) therapy. The purpose of this study was to assess the effectiveness of omeprazole-based triple therapy in Iranian children.Patients and methodsFifty-seven children with H. pylori-related gastroduodenal disease received 1-week triple therapy with a combination of omeprazole, amoxicillin and clarithromycin (according to the susceptibility test). Success of eradication was assessed by ¹³C-urea breath test and endoscopy.ResultsSixty-four patients (mean age 11.3 years; range 2.7–16 years) were included. Eradication was successful in 84.2% (95% confidence interval, 72.8% intention to treat).ConclusionOne-week triple therapy was effective for the eradication of H. pylori infection in children.     

Differential Expression of a Set of Genes in Follicular and Classic Variants of Papillary Thyroid Carcinoma

Fine-needle aspiration biopsy (FNA) is currently the best initial diagnostic test for evaluation of a thyroid nodule. FNA cytology cannot discriminate between benign and malignant thyroid nodules in up to 30% of thyroid nodules. Therefore, an adjunct to FNA is needed to clarify these lesions as benign or malignant. Using differential display-polymerase chain reaction method, the gene expression differences between follicular and classic variants of papillary thyroid carcinoma (PTC) and benign thyroid nodules were evaluated in a group of 42 patients. Computational gene function analyses via Cytoscape, FuncBASE, and GeneMANIA led us to a functional network of 17 genes in which a core sub-network of five genes coexists. Although the exact mechanisms underlying in thyroid cancer biogenesis are not currently known, our data suggest that the pattern of transformation from healthy cells to cancer cells of PTC is different in follicular variant than in classic variant.     

Transition m.3308T>C in the ND1 gene is associated with left ventricular hypertrabeculation/noncompaction

Though left ventricular hypertrabeculation/noncompaction (LVNC) is frequently associated with mitochondrial DNA (mtDNA) mutations, it has not been reported in association with the transition m.3308T>C of the NADH dehydrogenase subunit 1 (ND1) gene. The index patient is a 16-year-old Tunisian female who was investigated for a systolic murmur and cardiomegaly. Echocardiography revealed tricuspid insufficiency, moderate left ventricular dilatation, Ebstein's anomaly, a superior caval vein draining into the coronary sinus and, surprisingly, LVNC of the apex and the lateral wall. LVNC was absent in all other cardiologically investigated siblings. RNA and mtDNA sequence analysis revealed the known homoplasmic mutation m.3308T>C resulting in the replacement of the first amino acid methionine by threonine in the ND1 subunit of respiratory chain complex I. The m.3308T>C mutation was also present in the patient's mother and several other family members but absent in 350 controls. Additionally, the index patient carried the polymorphisms m.8248A>G in the COX2 gene and m.8468C>T in the ATP8 gene. It is concluded that LVNC may be associated with the known homoplasmic m.3308T>C mutation in the ND1 gene. However, the pathogenetic role of this mutation in the development of LVNC remains elusive.