Celiac Disease in Children with Diarrhea Is More Frequent than Previously Suspected

Imanzadeh, Farid; Sayyari, Aliakbar; Yaghoobi, Mohammad; Akbari, Mohammad Reza; Shafagh, Hamed; Farsar, A R

doi:10.1097/01.mpg.0000154012.10420.08

Cited by 27 publications

(19 citation statements)

References 15 publications

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“…We found that CD is present in about 9.2% of the patients coming with typical symptoms (12.1% (13/107) of the patients with chronic diarrhea) and 4.0% of those who come with atypical symptoms of malabsorption. Other studies from Iran also reported that CD is the most common cause of chronic nonbloody diarrhea in adults and children, ranging from 6.5% to 19% [15, 16]. These results indicate that classic presentation of malabsorption, specially with chronic diarrhea, is the main presentation of CD in our society.…”

Section: Discussionmentioning

confidence: 65%

Frequency of Celiac Disease in Adult Patients with Typical or Atypical Malabsorption Symptoms in Isfahan, Iran

Kouhestani

Karimi²,

Baghaei³

et al. 2012

Gastroenterology Research and Practice

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Aim. Atypical presentations of celiac disease (CD) have now been shown to be much more common than classical (typical) form. We evaluated the frequency of CD among adult patients with typical or atypical symptoms of CD. Materials and Methods. Patients referred to two outpatient gastroenterology clinics in Isfahan (IRAN) were categorized into those with typical or atypical symptoms of CD. IgA antitissue transglutaminase antibody was assessed and followed by duodenal biopsy. In patients for whom endoscopy was indicated (independent of the serology), duodenal biopsy was taken. Histopathological changes were assessed according to the Marsh classification. Results. During the study period, 151 and 173 patients with typical and atypical symptoms were evaluated (mean age = 32.8 ± 12.6 and 35.8 ± 14.8 years, 47.0% and 56.0% female, resp.). Frequency of CD in patients with typical and atypical symptoms was calculated, respectively, as 5.9% (9/151) and 1.25% (3/173) based on positive serology and pathology. The overall frequency was estimated as at least 9.2% (14/151) and 4.0% (7/173) when data of seronegative patients were also considered. Conclusions. CD is more frequent among patients with typical symptoms of malabsorption and these patients should undergo duodenal biopsy, irrespective of the serology. In patients with atypical symptoms, serological tests should be performed followed by endoscopic biopsy, and routine duodenal biopsy is recommended when endoscopic evaluation is indicated because of symptoms.

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Section: Discussionmentioning

confidence: 65%

Frequency of Celiac Disease in Adult Patients with Typical or Atypical Malabsorption Symptoms in Isfahan, Iran

Kouhestani

Karimi²,

Baghaei³

et al. 2012

Gastroenterology Research and Practice

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“…The true incidence evaluated by a North American study is about 0.5% to 1%, but many, if not most, of studied patients were asymptomatic members of high-risk groups [3, 4]. Recent epidemiological studies performed in North Africa and Asian areas also showed a high rate of CD: 0.53% in Egypt [5], 0.79% in Libya [6], 0.6% in Tunisia [7], 0.88% in Iran [8], 0.6% in Turkey [9], and 0.7% in India [10]. The classic form of CD typically presents in infancy and manifests as failure to thrive, diarrhea, abdominal distention, developmental delay, and, occasionally, severe malnutrition [11, 12], which can lead to a true medical emergency [11].…”

Section: Introductionmentioning

confidence: 99%

Atypical Celiac Disease: From Recognizing to Managing

Admou

Essaadouni

Krati

et al. 2012

Gastroenterology Research and Practice

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The nonclassic clinical presentation of celiac disease (CD) becomes increasingly common in physician's daily practice, which requires an awareness of its many clinical faces with atypical, silent, and latent forms. Besides the common genetic background (HLA DQ2/DQ8) of the disease, other non-HLA genes are now notably reported with a probable association to atypical forms. The availability of high-sensitive and specific serologic tests such as antitissue transglutuminase, antiendomysium, and more recent antideamidated, gliadin peptide antibodies permits to efficiently uncover a large portion of the submerged CD iceberg, including individuals having conditions associated with a high risk of developing CD (type 1 diabetes, autoimmune diseases, Down syndrome, family history of CD, etc.), biologic abnormalities (iron deficiency anemia, abnormal transaminase levels, etc.), and extraintestinal symptoms (short stature, neuropsychiatric disorders, alopecia, dental enamel hypoplasia, recurrent aphtous stomatitis, etc.). Despite the therapeutic alternatives currently in developing, the strict adherence to a GFD remains the only effective and safe therapy for CD.

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“…Как показали недавние эпидемиологи-ческие исследования, проведенные в развиваю-щихся странах, показатели распространенности целиакии в них сопоставимы с европейскими. Например, в Северной Африке они составили 0,53% в Египте, 0,79% в Ливии и 0,6% в Тунисе [21][22][23], на Ближнем Востоке -0,88% в Иране и 0,6% в Турции [24,25], в Индии -0,7% [26].…”

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Global epidemiology of celiac disease

2018

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Celiac Disease in Children with Diarrhea Is More Frequent than Previously Suspected

Abstract: CD is common among patients labeled as chronic diarrhea. In this subgroup, gluten-free diet may lead to a significant improvement in symptoms. Routine testing for CD may be indicated in all patients being evaluated for chronic diarrhea.

Cited by 27 publications

References 15 publications

Frequency of Celiac Disease in Adult Patients with Typical or Atypical Malabsorption Symptoms in Isfahan, Iran

Frequency of Celiac Disease in Adult Patients with Typical or Atypical Malabsorption Symptoms in Isfahan, Iran

Atypical Celiac Disease: From Recognizing to Managing

Global epidemiology of celiac disease

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