{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:18:13Z","timestamp":1787944693435,"version":"build-2784847793"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Celiac disease (CD) is a chronic immune-mediated disorder associated with a broad spectrum of extraintestinal manifestations, including hematological abnormalities. Although anemia and micronutrient deficiencies are well recognized, neutrophil morphological abnormalities have not been systematically investigated in pediatric CD; this study aimed to evaluate peripheral blood smear findings in children with CD compared with healthy controls. Methods: This retrospective case\u2013control study included 70 children with CD and 74 healthy controls; demographic characteristics, anthropometric measurements, hematological and biochemical parameters, and peripheral blood smear findings were analyzed and compared between groups. Results: Children with CD had significantly higher frequencies of underweight status (15.7% vs. 2.7%) and short stature (21.4% vs. 1.4%) than controls. Most hematological and biochemical parameters were comparable between groups, except for platelet counts and ferritin levels, which differed significantly. Pseudo-Pelger\u2013Hu\u00ebt anomaly (PPHA) was identified in 87.1% of children with CD versus 8.1% of controls (p &lt; 0.001), and neutrophil dysplasia was observed in 52.9% versus 1.4%, respectively (p &lt; 0.001). After adjustment for age and sex, CD remained strongly associated with PPHA (adjusted OR 81.19, 95% CI 28.65\u2013278.45), neutrophil dysplasia (adjusted OR 93.85, 95% CI 18.46\u20131724.96), and the combined presence of both abnormalities (adjusted OR 79.89, 95% CI 15.86\u20131461.89) (all p &lt; 0.001). ROC analysis demonstrated excellent discrimination between CD and controls (AUC = 0.924; sensitivity = 90.0%; specificity = 91.9%). Within the CD cohort, PPHA and dysplasia were not associated with celiac antibody positivity, gluten-free diet adherence, vitamin D deficiency, or comorbid conditions. Conclusions: To our knowledge, this is the first study to systematically evaluate peripheral blood smear morphology in pediatric CD, demonstrating a remarkably high prevalence of PPHA and neutrophil dysplasia. These findings suggest that neutrophil morphological abnormalities may represent an underrecognized hematological manifestation of pediatric CD, potentially reflecting chronic immune-mediated alterations in granulopoiesis. Further prospective studies are needed to clarify their pathogenesis, clinical significance, and reversibility following long-term gluten-free diet treatment.<\/jats:p>","DOI":"10.3390\/children13091158","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:33:52Z","timestamp":1787942032000},"page":"1158","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Prevalence of Pseudo-Pelger\u2013Hu\u00ebt Anomaly and Neutrophil Dysplasia in Children with Celiac Disease: A Retrospective Case\u2013Control Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Bur\u00e7ak","family":"Kurucu","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Ankara Etlik City Hospital, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclseren","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology, Ankara Etlik City Hospital, 06170 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref_1","first-page":"100786","article-title":"Pediatric celiac disease: A review for non-gastroenterologists","volume":"50","author":"Bingham","year":"2020","journal-title":"Curr. 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