Epidemiological, clinical, and histological presentation of celiac disease in Northwest China

Wang, Man; Kong, Wenjie; Feng, Yan; Lu, Jiajie; Hui, Wenjia; Liu, Weidong; Li, Zi-Qiong; Shi, Tian; Cui, Mei; Sun, Zhenzhu; Gao, Feng

doi:10.3748/wjg.v28.i12.1272

Cited by 6 publications

(1 citation statement)

References 48 publications

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“…However, in China, most patients with adult CD were males. 15 Some studies suggest no significant gender differences among patients diagnosed in late 50s. 16 …”

Section: Discussionmentioning

confidence: 99%

Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan

Butt,

Shahid,

Butt

et al. 2024

Euroasian Journal of Hepato-Gastroenterology

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A bstract Introduction Celiac disease (CD) is a systemic autoimmune enteropathy triggered by dietary gluten in genetically susceptible individuals. Celiac disease affects 0.6–1.0% of the population worldwide. The prevalence of CD in Pakistan is yet unknown due to under diagnosis and lack of awareness. Objective To determine a vast variety of presenting features in subtypes of CD to overcome the burden of disease. Materials and methods This was a prospective, comparative, cross-sectional study conducted at Gastroenterology department of Jinnah Postgraduate Medical Center, Karachi from December 2022 till June 2023. This study included all adult patients ≥18 years diagnosed with CD on the basis of clinical presentation, positive IgA and IgG anti-transglutaminase antibodies (value >12 IU/mL detected by ELISA followed by small intestinal biopsy classified as per Marsh criteria. The data obtained were analyzed on the statistical software SPSS version 23. Descriptive statistics were obtained by frequencies and percentages. Results About 142 patients were enrolled in the study, 103 (91.5%) had classical CD (CCD) whereas 36 (25%) had non-classical (NCCD). About 89 (62.7%) were females and 53 (37.3%) were males. The mean age was found to be 23 ± 6 years. Nutritional deficiencies including anemia, B12, folate, osteopenia and low body mass index (BMI) <18 was found more in CCD group as compared with NCCD group with significant p -values. Titers of anti-TTG between CCD and NCCD were not statistically significant. Hypothyroidism and PCOS were the most common associated conditions observed in adult CD patients. Conclusion In conclusion, CD in adults and has diverse presentations. Adults with unexplained extra-intestinal symptoms like anemia and bone pain should be investigated for CD. How to cite this article Butt N, Shahid B, Butt S, et al . Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan. Euroasian J Hepato-Gastroenterol 2024;14(1):24–29.

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“…However, in China, most patients with adult CD were males. 15 Some studies suggest no significant gender differences among patients diagnosed in late 50s. 16 …”

Section: Discussionmentioning

confidence: 99%

Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan

Butt,

Shahid,

Butt

et al. 2024

Euroasian Journal of Hepato-Gastroenterology

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Celiac disease in adult patients

Ciacci,

De Micco,

Di Stefano

et al. 2024

Pediatric and Adult Celiac Disease

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Current knowledge and “myths” about celiac disease among physicians in the Republic of Kazakhstan: A countrywide cross-sectional study

Kozhakhmetova

Aidossov

Kapassova

et al. 2022

Front. Public Health

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BackgroundCeliac disease (CD) is a common genetically predisposed autoimmune condition affecting the gut and other organs. Disease awareness is one of the key components of early case identification. This study aimed to assess awareness about CD among primary care physicians, who are the front-liners in suspecting the diagnosis, and other medical specialists.Methods and findingsThe questionnaire for this survey-based study was created based on the latest international guidelines on CD and included a consent form, 5 general questions (age, gender, etc.), and 10 specific questions concerning CD. Overall, 232 respondents from 13 country provinces (out of 14) and two republican cities were recruited for this study. Of them, 110 (47.4%) were primary care physicians and 122 (52.6%) other medical specialists, including 10 (4.3%) gastroenterologists. A scoring system was used to classify the level of awareness of participants into 3 categories, namely, poor, fair, and good. Analysis of responses revealed poor awareness in 59.4% of physicians, associated with work in republican/province/district/rural/village hospitals (p = 0.004), male gender (p = 0.006), and age of 40–50 years (p = 0.02). The most common “myths” about CD were the following: “symptoms are always obvious in children” or “in adults” (92.5 or 88.4% of respondents, respectively); “genetic mutation HLA DQ2/DQ8 causes the development of CD in all carriers of the mutation” (51.3%); “CD is a disease of children only” (12.5%); and “is triggered by dairy products” (8.6%). Genotyping of HLA DQ genes has been recommended in case of CD suspicion by every third respondent and was advocated as a “golden standard” confirmatory test by every fifth respondent. A quarter of respondents revealed their incorrect treatment strategies: gluten-free diet for 1 month, dairy-free diet, Helicobacter pylori eradication therapy, or responded that did not know how to treat. Overall, 93.5% of respondents expressed intention to learn more about CD, while the rest 6.5% thought that they knew enough, although their knowledge was poor.ConclusionThis study revealed a poor level of awareness among physicians in Kazakhstan and identified common misconceptions about CD, which potentially could lead to incorrect application of diagnostic tests, delay in diagnosis, and inefficient treatment. Development and implementation of educational programs as well as promotion of self-learning would increase awareness and unravel misconceptions.

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Epidemiological, clinical, and histological presentation of celiac disease in Northwest China

Cited by 6 publications

References 48 publications

Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan

Clinical Spectrum of Celiac Disease among Adult Population: Experience from Largest Tertiary Care Hospital in Karachi, Pakistan

Celiac disease in adult patients

Current knowledge and “myths” about celiac disease among physicians in the Republic of Kazakhstan: A countrywide cross-sectional study

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