Osteoporosis Can Be the Sole Presentation in Celiac Disease

Bommu, Veera Jayasree Latha; Mirza, Lubna

doi:10.7759/cureus.20602

Cited by 5 publications

(4 citation statements)

References 12 publications

(15 reference statements)

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“… 23 However, in a recent study, the sole presentation of CD was osteoporosis without any gastrointestinal symptom. 24 Thus, many researchers now advise to screen patients with refractory osteoporosis for underlying CD. Although the precise relationship between CD and excessive bone loss is unknown, as the condition affects the intestines, the absorption of calcium and vitamin D gets difficult; both of which are crucial for preserving bone density.…”

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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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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“…In some cases, it has been reported that patients could show osteoporosis with elevated serum alkaline phosphatase levels (ALP) and hyperparathyroidism as the sole presentation of CD [30]. Walker et al suggested that forearm bone density measurement, usually not screened when assessing BMD, is of aid to identify osteoporosis; it may be performed in addition to hip and lumbar spine BMD evaluation, which alone tends to underestimate the prevalence of osteoporosis [31].…”

Section: Pathologic Bone Alterations In Celiac Diseasementioning

confidence: 99%

Osteoporosis and Celiac Disease: Updates and Hidden Pitfalls

et al. 2023

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Celiac disease (CD) is an autoimmune disorder caused by gluten ingestion in genetically predisposed individuals. In addition to the typical gastrointestinal symptoms (e.g., diarrhea, bloating, and chronic abdominal pain), CD may also present with a broad spectrum of manifestations, including low bone mineral density (BMD) and osteoporosis. The etiopathology of bone lesions in CD is multifactorial and other conditions, rather than mineral and vitamin D malabsorption, may affect skeletal health, especially those related to the endocrine system. Here, we describe CD-induced osteoporosis in an attempt to enlighten new and less-known aspects, such as the influence of the intestinal microbiome and sex-related differences on bone health. This review describes the role of CD in the development of skeletal alterations to provide physicians with an updated overview on this debated topic and to improve the management of osteoporosis in CD.

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“…Co więcej, należy pamiętać, że u pacjentów pediatrycznych klasyczny obraz celiakii obejmuje nie tylko bóle brzucha i wzdęcia, ale także utratę masy ciała i zahamowanie wzrostu. Opóźnione dojrzewanie, brak miesiączki czy zaburzenia rozwojowe powinny skłaniać lekarzy do poszerzenia diagnostyki w kierunku celiakii i jak najszybszego włączenia leczenia [17].…”

Section: Objawyunclassified

Celiac disease - a review on recent advances in characteristics, diagnostic and treatments

ARTYKIEWICZ

CZARKOWSKI

GORCZYCA

et al. 2022

J Educ Health Sport

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Introduction and purpose: Celiac disease occurs in 1% of the general population. However, many cases remain unrecognized. The disease is a chronic immune-mediated disorder triggered by the ingestion of gluten that appears in individuals with genetic susceptibility. Celiac disease can develop in paediatric patients as well as adults. The purpose of this review is to analyze the newest information on the characteristics, diagnosis and treatment of patients with celiac disease. Material and methods: This review was based on available data collected in the PubMed database and published between 2015 and 2022. The research was done by looking through keywords such as: “celiac disease”, “Gluten-Free Diet”, “diagnosis” and “treatment”. Results: The diagnosis of celiac disease is most often delayed due to the broad spectrum of presentations. Screening of at-risk individuals is important to progress the diagnosis. It is additionally crucial to raise clinicians' attention to non-specific parenteral symptoms that may indicate celiac disease. The majority of the symptoms arise from nutritional deficiencies caused by intestinal malabsorption. According to scientific reports, the most common deficiencies of people with celiac disease are iron, folic acid, vitamin B12, fat-soluble vitamins and a calcium. Conclusions: Recent years have seen the emergence of research into new therapeutic options, but their efficacy and safety still need to be evaluated more thoroughly. Strict adherence to a gluten-free diet by patients is still the only treatment option at present. Celiac disease, due to the constant increase in knowledge about its pathogenesis, diagnosis and treatment is an important material for further research.

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Osteoporosis Can Be the Sole Presentation in Celiac Disease

Cited by 5 publications

References 12 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

Osteoporosis and Celiac Disease: Updates and Hidden Pitfalls

Celiac disease - a review on recent advances in characteristics, diagnostic and treatments

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