Neurological and psychosocial evaluation of pediatric celiac patients: Diet adherence-case control study

Abstract

Objective: The aim of this study was to evaluate the neurological evaluation of pediatric patients with celiac disease and to compare with adherence to gluten-free diet (GFD) and non-adherence GFD and to evaluate the behavioral characteristics of these patients. Methods: The study group consisted of patients with celiac disease diagnosed at the Pediatric Gastroenterohepatology outpatient clinic. The patients’ adherence with GFD was evaluated by history, physical examination and serological tests. Psychosocial and behavioral functioning were assessed using standardized tests consisted of the Turkish version of Strengths and Difficulties Questionnaire. Results: Thirty-six children were included in the study. The first group consisted of 17 patients and the second group consisted of 19 patients. In the first group, 2 patients (headache, vertigo) and in the second group 6 patients had neurological symptoms (headache, tremor, paresthesia). There was a significant difference between the two groups (p=0.02). There was a significant difference in behavioral difficulties (p<0.001) and peer relationship problems (p<0.001) between the first and second groups in the GGA subscales. There was no significant effect of disease duration on GGA total score and subscale scores. We determined that the mean GGA score and peer relationship problems score increased with the increase in the age at diagnosis and there was a high and advanced significant relationship between them. Conclusion: Diagnosis of the disease at an early age is very important especially in terms of diet adherence. Neurological findings, which are more common in adulthood and which are explained by gluten toxicity, should be detected in childhood and taking necessary precautions significantly affect the prognosis of the disease.