Celiac disease screening in Brazilian patients with osteoporosis

Abstract

Objective: To analyze if it is worthwhile to screen Brazilian osteoporotic patients for celiac disease (CD). Subjects and methods: One hundred patients with osteoporosis and 97 controls were evaluated for IgA-EmA (IgA anti-endomysial antibodies) by indirect immunofluorescence method and IgG-anti-tTG (tissue transglutaminase) by ELISA assay. Positive patients were invited to have gastrointestinal endoscopy with jejunal biopsy. Results: Two patients had positive IgG-anti-tTG test and one of them also showed positive IgA-EmA. Only the latter had a positive duodenal biopsy for CD. None of the controls were positive for either auto-antibodies. Conclusion: We observed low prevalence of CD in osteoporotic Brazilian patients. This finding does not support routine screening for CD in patients with osteoporosis in our geographic region.

Systematic review with meta‐analysis: the prevalence of coeliac disease in patients with osteoporosis

“…Our literature review identified eight relevant studies with a total of 3188 individuals with osteoporosis . Of these, 59 (1.9%) had CD.…”

“…When examining individuals with osteoporosis according to age at time of testing for CD, CD was somewhat higher in individuals tested at <60 years of age (1.8%; 1.3%‐2.3%), as compared to those ≥60 years (1.0%; 0.1%‐1.9%; Table ). Nonetheless, a meta‐regression analysis found no continuous relationship between age at testing and CD prevalence ( P = 0.917).…”

“…Coeliac disease was diagnosed in 1.7% (1.1%‐2.2%) of osteoporotic patients tested in Europe as opposed to 1.4% (0.6%‐2.2%) tested outside of Europe (Table ) . The prevalence of CD was 2.3% (0.8%‐3.7%) in studies restricted to women, and 1.5% (1.0%‐2.0%) in studies that included men (Table ) .…”

“…The review of all search results was conducted by ML and SM. Eight studies were deemed as relevant for our study (Table ; Figure S1 includes a flowchart for study inclusion).…”

“…We did so since earlier research has shown that using serology to estimate prevalence of CD will yield higher values than defining CD solely according to small intestinal biopsy findings . Positive serology was more frequent than biopsy‐verified CD in four studies already included in the main analysis . For this post‐hoc analysis we also included an additional four studies without data on biopsy‐verified CD .…”