1176 A Sex-Based Comparison of Initial Presentation and Disease Severity of Celiac Disease

Abstract

INTRODUCTION: The presenting symptoms of Celiac Disease (CD) in females were initially described as more severe and rapid in comparison to males1. However, a recent study implied these differences may not be as significant as once believed2. The primary objective of this study is to assess for sex differences in CD. METHODS: This study is a single center retrospective chart review of adult patients diagnosed with CD at an urban, tertiary hospital. Patients without clear documentation of initial presentation were excluded. Outcomes included age at diagnosis, demographic data, presenting symptoms, relevant clinical values, mode of diagnosis, and adherence to diet. RESULTS: We included 194 patients (77% females, n = 150) diagnosed between 1999 – 2017. Ethnicity was similar between sexes. Female patients had a lower mean age (38.7 yr in females; 42.0 yr in males) and lower hemoglobin at presentation (13.5 in females; 14.3 in males; P = 0.0019). Female patients on presentation had similar BMI but higher total cholesterol. Both sexes had similar presentation at time of diagnosis, most commonly GI symptoms and neurologic symptoms. More females presented with symptoms of anemia (9.3% of females; 2.3% of males). The majority of patients in each group were diagnosed by both biopsy and serology. Both sexes presented with a similar distribution of Marsh Classification and were similarly adherent to a gluten free diet. CONCLUSION: This study compared the presentation of CD between sexes. In support of recent literature, our study found that male and female patients have similar clinical presentations of CD. However, a few notable differences were noted. Namely, females presented at a younger age and more frequently presented with symptomatic anemia. Both sexes had similar marsh classification on initial diagnosis and had similar adherence to a gluten free diet. While more females carry the diagnosis of CD, clinicians should have a high index of suspicion for CD in both male and female populations.