Celiac disease in Middle Eastern and North African countries: A new burden?

Abstract

Celiac disease (CD) is now recognized as a common disorder among Middle Eastern (ME) and North African (NA) populations. The aim of this review is to assess the available data regarding CD in the ME and NA and to compare this information with that of Western countries. A literature review was performed using the electronic databases PubMed and Medline (1950-2008) as search engines, and "celiac disease" was used as a Mesh term. The search was limited to ME and NA countries. The prevalence of CD in ME and NA countries among low risk populations is similar to that of Western countries, but is higher in high risk populations such as those with type 1 diabetes. It is underestimated because of lack of clinical suspicion and lack of patient awareness. Clinical presentations in term of gastrointestinal, hematologic, skeletal, and liver manifestations are similar between both populations except for a high prevalence of short stature in some ME and NA countries. Few studies have addressed atypical or silent CD. As in the West, diagnosis is initially made by serological tests and is confirmed by small intestinal biopsies. Gluten-free diet is the main mode of treatment with a higher apparent adherence rate than in the West. Most disease complications result from malabsorption. The disease is strongly associated with HLA DQ2 and to a lesser extent with HLA DQ8 alleles. In conclusion, CD prevalence is underestimated, with little data available about its malignant complications. Disease parameters in the ME and NA are otherwise similar to those in Western countries.

Selected Probiotic Lactobacilli Have the Capacity To Hydrolyze Gluten Peptides during Simulated Gastrointestinal Digestion

“…In addition, gluten-free products are generally more expensive than their counterparts, and their availability varies around the world, especially in developing countries (28,29). It is estimated that gluten contamination of GFDs occurs for 32 to 55% of CD patients (30).…”

HLA Typing and Histopathologic Features of Patients with Celiac Disease-A Retrospective Study

“…Most of the CD patients have HLA DQ2 and DQ8 alleles which are responsible from 40% of genetic susceptibility to CD [9]. It has been indicated that the prevalance of DQ2 and DQ8 genes differs according to the different populations [18].…”

“…The new European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria is published in 2012 and recently the diagnosis of CD, according to this new criteria, is based on: gluten-dependent symptoms, Human Leukocyte Antigen (HLA) typing (presence of HLA-DQ2 and/or DQ8), CD-specific antibodies levels (anti-tissue transglutaminase type 2 (anti-TG2), antiendomysium (EMA) and characteristic histological changes [8]. CD is one of the most common genetic disorders with a prevalance of 1-2.67%, recently [9]. There is an increased risk (5-10%) of CD in first-degree relatives of CD patients [10].…”

Türk çocuklarında çölyak hastalığı ile ilişkili olası etmen ve belirtilerin değerlendirilmesi

“…Various studies still report that diarrhea is the most common symptom in celiac patients (19)(20)(21). While one of the most common causes of chronic diarrhea in Middle East and North Africa is CD, the incidence of CD was reported to be 4.7% in patients presenting with diarrhea and growth failure in Egypt (22)(23)(24). On the other hand, some studies have reported that diarhhea has been observed with a lower frequency in recent years (25,26).…”