Prevalence of Silent Celiac Disease in Patients with Dyspepsia

Abstract

Celiac disease (CD) has become more common than in the past, although it frequently remains undetected for long periods of time. One reason for this is failure by health care professionals to recognize the variable clinical manifestations of CD and to perform the appropriate tests to make the diagnosis. Although dyspepsia may be part of a clinical spectrum in CD patients, there are scarce data about its prevalence in silent CD. We aimed to determine the prevalence of CD in otherwise healthy dyspeptic patients by means of serologic screening followed by endoscopic biopsies if appropriate. Anti-endomysium antibody assay was positive in 3 of 196 patients. All 3 were female, ages ranged from 19-52 years (mean +/- SD age, 36 +/- 16 years). Duodenal biopsies were compatible with CD in all, whereas abnormal endoscopic findings were noted in 2. Therefore, a 1.5% prevalence of CD was observed in this study group. The odds ratio for CD was 2.57 (95% confidence interval) in comparison with the general population. CD should be kept in mind as a cause of dyspepsia during clinical activities. The association between these 2 conditions is, at most, weak, but a gluten-free diet may still bring symptomatic relief for dyspeptic symptoms in CD. During endoscopic examination for dyspepsia, if indicated, endoscopists should carefully inspect the duodenum for CD findings. Although routine serologic screening can not be recommended, it may be appropriate for the patients with refractory dyspepsia, especially females.

A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

“…The correlations with IgA EmA and intestinal biopsy were 100% (Table 2). This result is similar to the findings of Riestra et al [33] in Spain (2.2% also in women); Ozaslan et al [21] in Turkey (1.5% in women). In another Brazilian region, Lima et al [34] reported 1.4% positivity in women.…”

“…Point-of-care test in celiac disease be diagnosed at any age [1] . However, it frequently remains undetected for long periods of time, because of failure by health care professionals to recognize the disorder, probably due to the variable clinical presentation or failure to perform appropriate diagnostic tests [21] . In the present study, there was a young adult preponderance in all groups, indicating that it is important to exclude CD in the differential diagnosis of gastrointestinal complaints in this age group.…”

Evidence Against Routine Testing of Patients With Functional Gastrointestinal Disorders for Celiac Disease: A Population-based Study

“…Similarly, in other FGIDs including dyspepsia, the prevalence of CD has been reported to be higher than that in controls. 30, 31 However, because these studies were conducted in the secondary or referred population, unrecognized selection bias may account for these findings. Moreover, other studies including meta-analysis did not find significant associations between CD and dyspepsia.…”

Enteropatía sensible al gluten y dispepsia funcional

“…Observaron la existencia de atrofia vellositaria en 8 (5,3%) pacientes: 2 de 48 (4,2%) pacientes con dispepsia, 4 de 52 (6,4%) pacientes con síntomas de reflujo gastroesofágico y 1 de 17 (5,8%) pacientes con náuseas y/o vómitos. Existen otros estudios que han evaluado la prevalencia de EC en pacientes con dispepsia, mediante la realización de serología seguida de EDA y biopsias de duodeno en los positivos 32,33,37 . Estos trabajos también han demostrado una mayor frecuencia de EC (1,5-5,9%) en comparación con la población general.…”