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

Abstract

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.

Desafios na Investigação de Diarreia Crónica Malabsortiva: Um Caso Clínico

“…A histologia permanece o gold standard do diagnóstico [1][2][3][4][5][6][7] . Deve ser feita biopsia nos doentes com clínica sugestiva, independentemente da serologia, e nos assintomáticos com anticorpos positivos 5,11 . A melhoria ou eventual resolução clínica, laboratorial e histológica, no decurso da restrição de glúten, confirmam o diagnóstico [1][2][3] .…”

“…De acordo com diversos estudos, deve rastrear-se DC nos doentes com autoimunidade tiroideia, nomeadamente sob a forma de Tiroidite de Hashimoto e vice-versa [8][9][10][11][12][13][14] . O tratamento da DC diminui a probabilidade de desenvolver outras condições auto-imunes ao longo da vida, as complicações associadas e, no caso de coexistência de hipotiroidismo, melhora o seu controlo, reduzindo as necessidades de levotiroxina 8,10,12 .…”

Assessing of Celiac Disease and Nonceliac Gluten Sensitivity

“…CD manifestations in both children and adults may be difficult to recognize because of the variation in signs and symptoms associated with the condition. Most of the patients attending primary care and gastroenterology clinics present predominantly with gastrointestinal symptoms such as diarrhea, bloating, abdominal pain, and constipation [ 15 , 16 ]. Common symptoms in children under 5 years old include diarrhea, distension, and abdominal pain [ 17 ].…”

Evaluation of the Prevalence of Anti-transglutaminase 2 and 6 Antibodies in Patients with Sero-Positive Multiple Sclerosis

“…Gluten-sensitive enteropathy, dermatitis herpetiformis (DH), and gluten ataxia (GA) are the main types of gluten-related autoimmune diseases. 1 - 5 Several studies have shown a relationship between hypersensitivity in various organs and gluten intake, even in the absence of histological findings of celiac disease in intestinal biopsy, which is called gluten sensitivity (GS). 6 - 8 The GRDs are heterogeneous diseases, and their pathogenesis mostly includes an immunological attack on the central and peripheral nervous system which is accompanied by neurodegenerative changes.…”