The prevalence of celiac disease in children with attention deficit hyperactivity disorder

Introduction and aim: Attention deficit hyperactivity disorder (ADHD) is a developmental disorder of childhood. Bio-psycho-social factors may contribute to ADHD bu clear etiologic associations are missing. Celiac disease (CD) is an enteropathy that occurs against dietary glutene in genetically predisposed people. Besides classical findings, systemic findings may accompany CD. The neurological manifestations associated with CD are well identified but studies regarding the psychological and psychiatric problems with CD are insufficient. The definition of a possible association between the two common disorders of our country, AHDH and CD may offer new notions about the treatment and follow-up for ADHD.Material and Methods: The ADHD group consisted of 362 childred, aging between 5-15 years, followed as ADHD at İnonü University, Pediatric Neurology and Child Psychiatry departments between june 2009 and november 2010. The control group consisted of 390 children within same age group, having acute ilnessses and referred to the İnönü University Pediatrics polyclinic without nutritional problems. Both group members? serum tTG IgA and tTG IgG were studied and seropositive cases were undergone endoscopic duodenal biopsy.Results: Four of the ADHD group members had tTG IgA positivity (1/90-%1,1) and three of the control group members had tTG IgA positivity (1/130-%0,8). Comparison of the groups based on tTG IgA seropositivity revealed no significant difference. (p=0,716). Four of the seropositive cases of the ADHD group were undergone endoscopic duodenal biopsy and one case was found positive for celiac disease based on the Marsh-Oberhuber (1/362-%0,27) pathological classification. One of the seropositive cases of the control group was undergone endoscopic duodenal biopsy and pathological examiantion was negative for celiac disease.The mean body-mass index values of the ADHD and control group were 16,69±3,5 kg/m2 and 17,49±3,16 kg/m2 respectively and the difference was statistically significant (p=0,001). When compared based on the weight for height classification, ADHD group mean weight for height value of the overweight and obese patients was 120±11 and control group mean weight for height value of the overweight and obese patients was 117±10. ADHD group mean weight for height value of the cases with malnutrition was 80±6,80 and the control group value was 82±5,96 . Significant differences between the groups were observed (p=0,0001, p=0,037 respectively)Conclusion: CD seropositivity of the ADHD cases were not higher than the control group (1/90-%1,1). Biopsy proven CD prevalence of the ADHD group was lower than the normal population values of the literature (1/362-%0,27). Evidence favoring the screening of the ADHD patients for CD is not obtained but more healthy conclusions may be possible with further follow-up of the seropositive cases and studies held with broader series. ADHD may cause nutritional problems such as undernutrition and overnutrition. ADHD cases should be examined for nutritional problems and followed up with dietary recommendations.