Celiac disease in adults: casuistic from a referential center

Abstract

Forty-eight adult patients with celiac disease, between 15 and 68 years old (mean: 41 years) were studied. Sixty-seven per cent of the patients were female and 33% male. Most of the patients were white (98%).The main clinical features were diarrhea (90%), weight loss (70%) and abdominal pain (56%). On the physical exam, the main findings were pallor (40%), aphthous stomatitis (31%) and arthralgia (23%).Associated disorders also occurred: diabetes mellitus type I, osteoporosis and atopy (6% each), dermatitis herpetiformis and depression (4% each), hypothyroidism, hyperthyroidism, duodenal carcinoma and Gilbert syndrome (2% each). The histologic results according to Marsh criteria (modified by Rostami) were as follows: 10% type I; 21% type II; 19% type IIIa; 17% type IIIb and 33% type IIIc.The sensitivity and specificity for the IgA antiendomysium antibody were 92 and 100%, respectively, when considering the whole group of patients; however, the sensitivity (but not the specificity) decreased to 86% when taking into account only the group of patients with mild histologic alterations (Marsh I, II and IIIa).In general, our results were similar to those described in developed countries, pointing out that celiac disease might have the same spectrum of presentation regardless of the region studied.