Carotid intimal medial thickness in children with celiac disease

Introduction: Increasing cardiovascular risk in celiac disease (CD) may be attributed to the chronic systemic inflammation and unfavorable biochemical profile leading to accelerated atherosclerosis. Carotid intimal medial thickness (CIMT) has emerged as a direct marker of the early atherosclerosis as compared to traditional biochemical markers. Objectives: The aim of this study was to evaluate the CIMT in children with CD aged 1–16 years. Materials and Methods: A cross-sectional observational study was conducted at the department of Pediatrics and Radio Diagnosis in a tertiary care hospital of New Delhi. Thirty-six children with CD with age- and sex-matched controls were enrolled. CIMT for the anterior and posterior walls on each side was measured, and the mean CIMT was obtained for all the enrolled children. Results: The mean right-sided CIMT was significantly higher in cases (0.053±0.009 cm vs. 0.039±0.007 cm, p=0.000). The mean left-sided CIMT did not significantly differ between the groups (0.051±0.009 cm vs. 0.048±0.055 cm, p=0.702). The mean CIMT (right and left together), although higher in Celiacs, was not significantly different from controls (0.052±0.008 cm and 0.044±0.029 cm, p=0.114). However, a significant positive correlation between the age of the patients, age at the onset of symptoms, and CIMT was noted. Conclusion: Although we could not demonstrate statistically significant results, the mean CIMT and the right-sided measurements were significantly higher in cases than in controls

Identification of Markers that Distinguish Monocyte-Derived Fibrocytes from Monocytes, Macrophages, and Fibroblasts

The processes that drive fibrotic diseases are complex and include an influx of peripheral blood monocytes that can differentiate into fibroblast-like cells called fibrocytes. Monocytes can also differentiate into other cell types, such as tissue macrophages. The ability to discriminate between monocytes, macrophages, fibrocytes, and fibroblasts in fibrotic lesions could be beneficial in identifying therapies that target either stromal fibroblasts or fibrocytes. and in sections from human lung. We found that markers such as CD34, CD68, and collagen do not effectively discriminate between the four cell types. In addition, IL-4, IL-12, IL-13, IFN-γ, and SAP differentially regulate the expression of CD32, CD163, CD172a, and CD206 on both macrophages and fibrocytes. Finally, CD49c (α3 integrin) expression identifies a subset of fibrocytes, and this subset increases with time in culture.These results suggest that discrimination of monocytes, macrophages, fibrocytes, and fibroblasts in fibrotic lesions is possible, and this may allow for an assessment of fibrocytes in fibrotic diseases

Clinical Spectrum in Celiac Patients Attending a Tertiary Care Centre in Northern India

Background: Celiac disease generally is characterized by gluten dependent clinical manifestations. Clinically there may be symptoms of frank mal-absorption or predominant extra intestinal manifestations. Aim: to study the clinical spectrum of children with celiac disease. Methods: 360 children between the age group of 1-18 years diagnosed with celiac disease were enrolled into the study and details about the symptoms were recorded. Results: 27.8% patients had purely gastrointestinal symptoms and 13.9% of the patients had non gastrointestinal presenting features alone. But the majority of the patients i.e. 58.3% of patients had both gastrointestinal and other clinical features. Conclusion: With such varied clinical spectrum, the diagnosis is often missed in search of a more defined and common diagnoses. Hence is the need to have a high index of suspicion for the diagnosis of celiac disease