| Abstract | Cilj istraživanja: Istražiti povezanost neuroloških poremećaja sa celijakijom i upalnom bolesti crijeva (Crohnova bolest, ulcerozni kolitis i nedeterminirani kolitis) u dječjoj i adolescentnoj dobi. Proučiti pojavljuju li se u istraživanoj skupini bolesnika iste neurološke manifestacije koje su opisane u literaturi i dosadašnjim istraživanjima.
Materijali i metode: Istraživanje je provedeno retrospektivno prikupljanjem podataka iz dostupne bolničke dokumentacije u Klinici za dječje bolesti KBC-a Split u periodu od 1. siječnja 2015. do 31. prosinca 2019. U istraživanje su uključena 122 bolesnika s dijagnozom upalne bolesti crijeva ili celijakije. Ispitanicima su analizirani podaci: spol bolesnika i dob prilikom dijagnoze autoimune bolesti crijeva, prisutnost i tip neuroloških simptoma te dob u kojoj je došlo do manifestacije. Obrada podataka napravljena je u statističkom paketu SPSS 20. Korišteni su Mann Whitney U test i Hi-kvadrat test. Rezultati su interpretirani na razini značajnosti P <0,05.
Rezultati: Najviše bolesnika je bolovalo od Crohnove bolesti (35,2%), potom ulceroznog kolitisa (30,3%) pa celijakije (27,9%). Udio djece s neurološkim simptomima u skupini oboljelih od celijakije je 32,4% , ulceroznog kolitisa 16,2% i Crohnove bolesti 4,7%. Postoji statistički značajna povezanost neuroloških simptoma s vrstom bolesti (P=0,005). Udio neuroloških simptoma u celijakiji za 2 puta je veći nego udio neuroloških simptoma u oboljelih od ulceroznog kolitisa i za 6,9 puta je veći nego udio neuroloških simptoma u oboljelih od Crohnove bolesti. Udio neuroloških simptoma za 3,4 puta je veći u oboljelih od ulceroznog kolitisa nego u oboljelih od Crohnove bolesti. Najčešći neurološki simptom u istraživanoj skupini je glavobolja, a ostale neurološke manifestacije su: epilepsija, cerebrovaskularna bolest, pervazivni razvojni poremećaj, zastoj u psihomotornom razvoju i tikovi.
Zaključak: Pronađene neurološke manifestacije opisane su u literaturi, a ovo istraživanje potvrdilo je povezanost neuroloških simptoma s autoimunim bolestima crijeva i slaže se s rezultatima drugih istraživanja. Upalne bolesti crijeva i celijakija su kronične bolesti kojima je potrebno dugoročno praćenje liječnika gastroenterologa, ali iako neurološke manifestacije nisu učestale, određen dio bolesnika ih ima ili će ih razviti stoga je važno pravovremeno prepoznavanje, a može biti potrebno i dugoročno praćenje kod neurologa i u odrasloj dobi. |
| Abstract (english) | Objectives: To investigate the association of neurological disorders with celiac disease and inflammatory bowel disease (Crohn's disease, ulcerative colitis and indeterminate colitis) in children and adolescents. To investigate whether there are neurological manifestations in the research group of patients that have been described in the literature and previous research.
Material and methods: The research was done retrospectively by collecting data from the available hospital documentation in the Clinic for children's diseases in University Hospital of Split in the period from 1. January 2015. to 31. December 2019. The study included 122 patients diagnosed with inflammatory bowel disease or celiac disease. The data we analysed in the research: the sex of the patient and the age at the time of the diagnosis of autoimmune bowel disease, the presence and the type of neurological symptoms and the age at which the manifestation occurred. Data processing was done in the statistical package SPSS 20. Mann Whitney U test and Chi-Square test test were used. The results were interpreted at a significance level of P <0.05.
Results: The most patients suffered from Crohn's disease (35.2%), followed by ulcerative colitis (30.3%) and celiac disease (27.9%). The proportion of children with neurological symptoms in the group of patients with celiac disease was 32.4%, ulcerative colitis 16.2% and Crohn's disease 4.7%. There is a statistically significant association of neurological symptoms with the type of disease (P = 0.005). The share of neurological symptoms in celiac disease is 2 times higher than the share of neurological symptoms in patients with ulcerative colitis and 6.9 times higher than the share of neurological symptoms in patients with Crohn's disease. The proportion of neurological symptoms is 3.4 times higher in patients with ulcerative colitis than in patients with Crohn's disease. The most common neurological symptom in the study group is headache, and other neurological manifestations are: epilepsy, cerebrovascular disease, pervasive developmental disorder, psychomotor developmental delay and tics.
Conclusion: These neurological manifestations have been described in the literature and this study confirmed the association of neurological symptoms with autoimmune bowel diseases. Inflammatory bowel diseases and celiac disease are chronic diseases that require long-term follow-up by a gastroenterologist, but although neurological manifestations are uncommon, some patients develop them, so timely recognition is important, and long-term follow-up by neurologists may be necessary in adulthood. |
