Prevalence of associated disorders in Indian patients with celiac disease

Abstract

Celiac disease (CD) is an immune-mediated disorder that may be associated with various diseases that share a similar pathogenic immune mechanism. This study reports on the prevalence of various diseases in a cohort of CD patients in northern India. Patients diagnosed with CD based on modified ESPGHAN criteria were prospectively evaluated for associated concomitant diseases. Of the 363 patients evaluated, 207 (57.0 %) were male. The mean age was 19 years. Seventy-one percent of patients presented with typical diarrheal disease, while 29 % presented with atypical nondiarrheal disease. One or more associated diseases were noted in 70 (19.2 %) patients. Liver diseases were the most common association. Portal hypertension was present in 33 (9 %) patients; chronic liver disease was the underlying cause in 17 patients, while noncirrhotic causes were noted in 16 patients. Type 1 diabetes was seen in 13 and hypothyroidism in 11 patients. Other unreported or rarely reported associated diseases were also found in some of the patients. Associated comorbid diseases are common, and may need to be actively screened, in Indian CD patients.

Celiac disease in the East and the West: Bridging the gaps between the guidelines and their implementation in daily practice is mandatory

“…Traditionally, CeD was thought to be uncommon in India; however, an increase in the number of cases had been recognized in late 1990 and 2000 onwards [11][12][13][14][15][16]. Three population-based studies, two from the northern parts of India and another multi-centric pan Indian study, showed that the overall prevalence of CeD in India is 0.67% and 1.2% in northern parts of India [17][18][19].…”

Celiac Disease Screening in Southern and East Asia

“…Most of the subsequent reports on CD came from the northern part of India (States of Punjab, Haryana, Delhi, Rajasthan, Uttar Pradesh), where wheat is the staple dietary cereal [6,7,8,9,10,11,12,13,14,25,26,27,28]. …”

“…Although there has been an increase in the number of publications on CD from the Asian region, there is a paucity of literature on its prevalence in most Asian nations, with the exception of India [6,7,8,9,10,11,12,13,14]. Additionally, few case reports and short reports are available from China, Pakistan and Japan [15,16,17,18,19,20].…”

Association of celiac disease and portal hypertension: Cirrhotic or noncirrhotic

“…Association of celiac disease (CD) and chronic liver disease (CLD) has been well described [2,3]. In this series, the mean age of patients was 28.8 years.…”

“…In a study of liver explants, which were initially thought to be having CC, NCPF was found to be an important cause of end-stage CLD considered for liver transplantation [8]. In a recent study, NCPF was found to be associated with CD in 12 % of cases [3]. Etiology of NCPF is largely not known; however, infection and immune mechanisms may play important roles, which have also been described in the pathogenesis of CD.…”