Browsing by Author "Prokić, Dragan (6603769235)"

Introduction/Objective The objective of the paper is to assess the applicability of serum anti-tissue transglutaminase (tTG) antibodies IgA and IgG concentration and HLA-DQ2/DQ8 typing as a non-invasive alternative to duodenal biopsy in diagnosing celiac disease (CD) in pediatric population. Methods A prospective cohort study included a total of 179 pediatric patients aged 1–18 years. Determination of tTG IgA and tTG IgG antibodies and human leukocyte antigen (HLA) DQ2/DQ8 typing was performed for all patients. Histology of duodenal biopsies was interpreted by the modified Marsh scoring system. Results The diagnosis of CD was confirmed in 101 (56%) patients of the studied population. In cases of CD, HLA-DQ2/DQ8 was positive in 100 patients (99%). The tTG IgA antibodies in concentration higher than 100 U/ml were detected in 77 (76.2%) of the CD patients and in significantly smaller number for tTG IgG [29 (28.7%)] (p < 0.001). Statistically highly significant association of duodenal lesions Marsh grade 3 with concentration of tTG IgA 10-fold higher than the upper level of normal (ULN) was established (p < 0.001) Conclusion Concentration of tTG IgA 10-fold higher than ULN is significantly positively correlated with Marsh grade 3 histopathology findings. Specific antibodies determination in combination with HLA-DQ2/ DQ8 typing proves to be sufficient for a diagnosis of CD, supporting the fact that duodenal biopsy may be avoided in a significant majority of patients – 75%. © 2023, Serbia Medical Society. All rights reserved.

Introduction/Objective Strict gluten-free diet for life is the only treatment for patients with coeliac disease. Limited selection of food options can affect their quality of life and cause problems in acceptance by their peers. The aim was to examine the subjective quality of life experience in children and adolescents with coeliac disease and to obtain a comprehensive representation of physical and mental impairments and social functioning compared to their healthy peers. Methods The study was conducted as a cross-sectional study. It included 116 respondents aged 5-18 years with coeliac disease and 116 healthy children of similar age and sex. A Serbian version of Pediatric Quality of Life Inventory (PedsQL) was used to measure the quality of life in children. Descriptive statistics were calculated to analyze all results, while t-test was used to compare them. Results The mean value of total PedsQL score was lower in the coeliac disease patients (75.89 ± 20.35) than in the controls (86.35 ± 11.13). Additionally, the experimental group reported lower all PedsQL Scale scores than the control group in the domains of psychosocial, school, social, and emotional functioning. However, there was no statistically significant difference on the physical health scale. These results were the same in all age groups among both males and females. Conclusions The disturbance of health-related quality of life in children and adolescents with coeliac disease is significant and the quality of life is lower if compared to their healthy peers. © 2019, Serbia Medical Society. All rights reserved.

Introduction. Annular pancreas is a rare congenital anomaly in which a band of the pancreatic tissue, in continuity with the pancreatic head, completely or incompletely surrounds the descending part of the duodenum. An abnormal pancreatic development can cause complete annular pancreas, partial annular pancreas, and pancreas divisum. Complete annular pancreas is diagnosed in newborns, while the diagnosis of the partial annular pancreas is more frequently established in adults. The most reliable diagnostic methods are computed tomography and magnetic resonance cholangiopancreatography. The anomaly is treated surgically, using bypass procedures. Case report. A 12-year-old girl presented malnourished, with occasional feeding problems, vomiting, heartburn, and pain from infancy. The upper gastrointestinal series showed an extremely dilated stomach, the first and the second part of the duodenum. An endoscopic exam revealed the dilated stomach, pylorus, and the first and the second part of the duodenum with retained contrast, while the entrance of the endoscope into the third part of the duodenum was not possible. Computed tomography showed pancreatic tissue encircling the second part of the duodenum and the characteristic "crocodile jaw" sign. Roux-en-Y duodenojejunostomy was performed as a bypass procedure. Conclusion. The complete annular pancreas is a well-known and easily diagnosed anomaly in newborns. The partial annular pancreas is often poorly recognized, especially in patients who do not present with marked duodenal obstruction. Unrevealed, it causes chronic problems in food intake, with possible serious complications. Although a very rare condition in the pediatric population, partial annular pancreas should be taken into consideration in unclear cases of chronic poor oral food intake and vomiting. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.