Extraintestinal clinical manifestations of non-celiac gluten sensitivity in the pediatric age group: an integrative review
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Abstract
Introduction: Gastrointestinal diseases related to gluten or wheat ingestion are becoming more and more diagnosed. The emergence of a large number of patients with intestinal and extraintestinal symptoms who show sensitivity to a gluten diet without evidence of celiac disease or wheat allergy, contributed to the identification of a new gastrointestinal disorder related to gluten, syndrome defined as non-celiac gluten sensitivity. Objective: To carry out bibliographic research on the extraintestinal manifestations of non-celiac gluten sensitivity by analysis of data from studies carried out worldwide involving pediatric patients. Data Source: This review is based on studies published in PubMed, LILACS and MEDLINE database over the last 10 years. For this, the descriptors “Non-celiac”, “Gluten sensitivity”, “Child”, “Symptoms” were used. Data synthesis: There was a frequente complaint of fatigue, with scientific evidence (p<0.001) of worsening when there was ingestion of a diet containing gluten. Likewise, muscle and joint pain, migraine, memory loss/foggy thoughts, dizziness, ataxia and peripheral neuropathy, in addition to asthma or rhinitis, were reported in a small percentage. The presence of neuropsychiatric symptoms such as compulsive thoughts and fears were found in patients with non-celiac gluten sensitivity, in addition to weight and height deficiency related to a gluten-containing diet. Conclusion: Neuropsychiatric, dermatological, allergic, endocrine and musculoskeletal disorders in children should also be considered as an association in chronic gastrointestinal complaints, and the diagnosis of non-celiac gluten sensitivity is relevant for clinical investigation and better prognosis of these patients.
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References
1. Ruemmele, F. M. Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain. Ann Nutr Metab. 2018 Feb 19; 73(Suppl 4): 39-46. doi: 10.1159/000493929. PMID: 30783043.
2. Ashtari, S, Pourhoseingholi, MA, Rostami, K, Aghdaei, HA, Rostami Nejad, M, Busani, L, Tavirani, MR, Zali, MR. Prevalence of gluten-related disorders in Asia-Pacific region: a systematic review. J Gastrointestin Liver Dis. 2019 Mar;28(1):95-105. doi: 10.15403/jgld.2014.1121.281. sys. PMID: 30851178.
3. Sergi, C, Villanacci, V, Carroccio, A. Non-celiac Wheat Sensitivity: Rationality and Irrationality of a Gluten-Free Diet in Individuals Affected with Non-Celiac Disease: A Review. BMC Gastroenterol. 2021 Jan 6;21(1):5. doi: 10.1186/s12876-020-01568-6. PMCID: PMC7788993.
4. McAllister, BP, Williams, E, Clarke, KA. Comprehensive Review of Celiac Disease/Gluten-Sensitive Enteropathies. Clin Rev Allergy Immunol 2019 Oct;57(2):226-243. doi: 10.1007/s12016-018-8691-2.PMID: 29858750.
5. Elli, L, Branchi, F, Tomba, C, Villalta, D, Norsa, L, Ferretti, F, Roncoroni, L, Bardella, MT. Diagnosis of Gluten Related Disorders: Celiac Disease, Wheat Allergy and Non-Celiac Gluten Sensitivity. World J Gastroenterol. 2015 Jun 21;21(23):7110-9. doi: 10.3748/wjg.v21. i23.7110. PMID: 26109797; PMCID: PMC4476872
6. Catassi, C, Elli, L, Bonaz, B, Bouma, G, Carroccio, A, Castillejo, G. et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015 Jun 18;7(6):4966-77. doi: 10.3390/ nu7064966. PMID: 26096570
7. Francavilla, R, Cristofori, F, Verzillo, L, Gentile, A, Castellaneta, S, Polloni, C, Giorgio, V, Verduci, E, Dʼangelo, E, Dellatte, S, Indrio, F. Randomized Double-Blind Placebo-Controlled Crossover Trial for the Diagnosis of Non-Celiac Gluten Sensitivity in Children. Am J Gastroenterol 2018 Mar;113(3):421-430. doi: 10.1038/ajg.2017.483. PMID: 29380821
8. Volta, U, Bardella, MT, Calabrò, A, Troncone, R, Corazza, GR. An Italian Prospective Multicenter Survey on Patients Suspected of Having Non-Celiac Gluten Sensitivity. BMC Med. 2014 May 23;12:85. doi: 10.1186/1741-7015-12-85. PMID: 24885375; PMCID: PMC4053283
9. Camhi, SS, Sangal, K, Kenyon, V, Lima, R, Fasano, A, Leonard, MM. Pediatric Nonceliac Gluten Sensitivity: a Gluten-Related Disorder Treatment Center Experience. J Pediatr Gastroenterol Nutr. 2019 Aug;69(2):200-205. doi: 10.1097/MPG.0000000000002335. PMID: 30908383.
10. Menéndez, L, Guzmán, L, Rúa, EC, Bem, R. Arch Argent Pediatr. 2015 Apr;113(2):e83-7. doi: 10.5546/aap.2015.e83. PMID: 25727839
11. Kraijenhoff, GPS, Smit, MJM, Van Vlerken, RHT, Mearin Manrique, ML. Psychiatric Symptoms in a Child with Gluten Sensitivity. Ned Tijdschr Geneeskd. 2019 Mar 14;163:D2900. PMID: 30945820.
12. Saneifard, H, Sheikhy, A, Karbasian, F, Eslamian, G, Shakiba, M, Babaie, D. Non-Celiac Gluten Sensitivity as a Rare Cause of Growth Retardation in Children: A Case Series Study. Gastroenterol Hepatol Bed Bench Fall 2021;14(4):362-366. PMID: 34659665; PMCID: PMC8514215.