Are children with attention-deficit/ hyperactivity disorder (ADHD) more likely to develop celiac disease? A prospective study

Purpose
The aim of this study was to evaluate whether the prevalence of celiac among attention-deficit/hyperactivity disorder (ADHD) patients is higher than among the normal population.

Methods
The present study was a prospective one investigating ADHD children referred to the Neurology Clinic and Pediatric Ward at Amir Al-Momenin Hospital of Zabol (Sistan and Baluchestan, Iran) in 2019 after their parents’ signing of a consent form. All patients underwent Biocard™ Celiac and serology tests. Data were analyzed with SPSS version 21 software.

Results
Of all 76 ADHD children undergoing a serum IgA antibodies concentration test, 58 (76%) were male and 18 (23.7%) were female. The mean age of the children was 6.9 ± 2.4, ranging from 2 years to 12 years. The diagnosis of IgA immunodeficiency was rejected for all children based on total serum IgA antibody results. The overall mean anti-tissue transglutaminase (TTG) level was 6.8 ± 5.3 U/ml, ranging from 0.2 to 37 U/ml. There was no significant difference regarding TTG levels between boys and girls (5.1 vs. 6.0) U/ml. Based on the anti-TTG level results, no celiac case was found among the ADHD patients.

Conclusions
There is as yet no evidence suggesting a link between celiac disease and ADHD. Thus, routine celiac disease screening when evaluating for ADHD (and is not recommended). However, the possibility of untreated celiac disease predisposing an individual to ADHD-like behaviors should be considered. Hence, physicians are recommended to evaluate a broad range of physical symptoms, in addition to typical neuropsychiatric symptoms, when evaluating ADHD patients.